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Treatment should be started with a beta-blocker rather than a diuretic. Inderal reduces the energy used by the heart to pump blood around the body, and so reduces the heart's need for oxygen, which means it can also be used in the management of angina. Propranolol can, in certain patients, be used alone or as an initial agent in patients in whom, in the judgment of the physician, treatment should be started with a beta-blocker rather than a diuretic. The elevated outflow pressure gradient which is exacerbated by beta-adrenergic receptor stimulation.
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