Clinical Relevance of Differences between Various Beta-Blockers

More than 15 beta-blockers are available today. They represent a class I recommendation in major cardiovascular disorders such as hypertension, coronary heart disease and chronic heart failure. If in hypertension and coronary heart disease their favorable action is considered a class effect, in heart failure some of them are of more benefit than others. Bisoprolol, carvedilol and metoprolol proved in important clinical trials significant reductions in mortality and morbidity in patients with different stages of heart failure, from asymptomatic ventricular dysfunction to NYHA class IV heart failure. The newcomer nebivolol reduced morbi-mortality in old and very old patients as shown in the recently presented SENIORS study.