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Abstract
The benefit/risk ratio of β- blocking drugs is reviewed in the light of many years of widespread use. It is reasonably certain that the ‘practolol syndrome’ will not occur in association with the currently available and commonly prescribed β- blockers. Other predictable side effects, such as bradycardia, fatigue and cold peripheries are discussed, as well as the possibility of exacerbation of obstructive airways disease, heart failure and intermittent claudication while on β- blocking drugs. The incidence of these and other side effects is discussed in relation to the pharmaco- kinetic properties of various β- blockers and it is concluded that all β- blockers have a high benefit/risk ratio and that the ideal β- blocker profile for optimal safety and acceptability is high cardioselectivity plus high hydrophilicity (low lipid solubility).
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