Ladage D et al. – Acute treatment with beta–blockers modifies local muscular metabolic properties and impairs endurance exercise capacity whereas the influence of chronic is debated controversially.

• For the past 40 years, beta–blockers have been widely used in cardiovascular medicine, reducing morbidity as well as mortality.
• Beta–blockers are currently used in a number of cardiovascular conditions such as systolic heart failure, postmyocardial infarction, and in prevention and treatment of arrhythmias.
• They are not recommended as the first line antihypertensive therapy, particularly in the elderly, unless there are specific indications.
• Despite the benefits of beta–blockers, tolerability concerns in patients with co–morbidities have limited their use.
• Some of these problems were overcome with the discovery of cardioselective beta–blockers.
• The third generation beta–blockers have additional properties of vasodilatation and advantages in terms of minimizing the adverse effects of beta–blockers.
• Some of the advantages include improvement of insulin resistance, decrease in cholesterol as well as alleviation of erectile dysfunction.