How do you recommend mitigating the risks of using beta blocker and clonidine therapy in combination for management of hypertension?

Beta blockers vary in lipophilicity, which affects blood-brain barrier permeability. Propranolol and metoprolol readily cross the blood-brain barrier, while other beta-blockers like nebivolol do not. The CNS side effects of fatigue, depression, and insomnia are more likely to worsen if using a lipop...

Sometimes both are indicated. Simply do a 3 day Zio monitor to exclude significant bradycardia.

A nice review of beta blockers and their crossing of the CNS barrier to avoid side effects. Occasionally, beta blockers may be used for more than just hypertension, and therefore may be first-line agents for that purpose.