The p-receptor blocking agents have widespread and important uses in the management of cardiac arrhythmias, angina pectoris, and hypertension. Their uses in these conditions are reviewed in Chapters 16, 17, and 20, respectively. Even though acute administration of p-blockers can precipitate congestive heart failure in patients who are largely dependent on enhanced sym pathetic nerve activity to maintain sufficient cardiac output, the p-blockers have been shown to be quite useful in the long-term management of patients with mild to moderate heart failure. The p-blockers also offer proven benefit in preventing the recurrence of a myocardial infarction (MI). For this purpose, it is best if p-blocker therapy is instituted soon after the MI and continued for the long term. Other therapeutic applications of the p-blockers are discussed later in the chapter.
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