Insights on β‐blockers for the treatment of hypertension: A survey of health care practitioners

A quantitative survey was completed by 103 primary care physicians (PCPs) and 59 cardiologists who regularly prescribed β‐blockers to assess knowledge and use of this heterogeneous drug class for hypertension. More cardiologists than PCPs chose β‐blockers as initial antihypertensive therapy (30% vs 17%, P < 0.01). Metoprolol and carvedilol were the most commonly prescribed β‐blockers. Cardiologists rated “impact on energy” and “arterial vasodilation” as more important than PCPs (P < 0.05/<0.01, respectively). Awareness of vasodilation was greater for carvedilol (52%) than nebivolol (31%). Association between β‐blockers and clinical variables included nebivolol with β(1)‐selectivity, nebivolol and carvedilol with vasodilation and efficacy in older patients and African Americans, metoprolol with heart rate reduction, and atenolol and metoprolol with weight gain and hyperglycemia. Physicians preferred prescribing β‐blockers with lower risk of incident diabetes. Clinical practice guidelines influenced physician prescribing more than formularies or performance metrics. This survey captures physicians’ perceptions/use of various β‐blockers and clinically relevant knowledge gaps.