Table of Contents


Always Include
Optional
Rarely Needed


Beta-Blocker Statement

What to Send

  • Beta-blockers that have been tried and failed.
  • If other beta-blockers would not be as effective.
  • If other beta-blockers would cause adverse effects (e.g. contraindicated).


Common Beta-Blockers

  • Acebutolol (Sectral)
  • Atenolol (Tenormin)
  • Bisoprolol (Zebeta)
  • Metoprolol (Lopressor, Toprol)
  • Nadolol (Corgard)
  • Nebivolol (Bystolic)
  • Propranolol (Inderal)


Hospitalization Risk

Has the patient recently been hospitalized or are they at significant risk of being hospitalized due to hypertension or associated conditions?

What to Send

  • Hospitalized recently due to hypertension or associated conditions.
  • At high risk of hospitalization due to hypertension or associated conditions.
  • History of hospitalization due to hypertension or associated conditions.

Other Drugs

Have other drug been taken for the patient's condition?

What to Send

  • Any other type of drug tried such as beta blockers (e.g. metoprolol), calcium channel blockers (e.g. amlodipine), or diuretics (e.g. hydrochlorothiazide).