RECOMMENDATIONS Salbutamol should be used with caution in patients with

cardiovascular disease. If used, dosing should be individualized and the therapeutic

response monitored to limit side effects. Asthma is a compelling contraindication to the use of beta-

blockers as antihypertensives. Metoprolol may worsen the symptoms of heart failure and

reduce the effects of salbutamol. An alternative drug that can be used is Nebivolol. It is a third-generation beta-1 selective blocker that is approved

for treatment of hypertension. Nebivolol shows similar efficacy in treating

hypertension, and with better tolerability.