Β-blockers – all we need to know Review article
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Published:
Jun 30, 2014
Keywords:
β-blockers, cardioselectivity, vasodilation
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Abstract
B-blockers are basic drugs used in cardiovascular diseases. Mechanism of beta-blockers action is to blockade of the β-adrenergic receptor and thereby inhibit the sympathetic nervous system. β-blockers are different from each other a number of pharmacological features such as cardioselectivity, the presence of intrinsic sypathomimetic activity, vasodilating properties and lipophilicity. These properties result in large differences between the drugs in the group, and various hemodynamic and metabolic effects in their application. They are essential medicines in treatment of hypertension, ischemic heart disease and heart failure in the absence of contraindications. The benefits of their use in these diseases has been confirmed in several clinical trials. When choosing β-blockers, we should take into account the determined clinical situation and the pharmacological properties of the drug in order to obtain the effectiveness of treatment and avoid the occurrence of side effects, which are mainly responsible for noncompliance by the patient. Currently in clinical practice are strongly preferred cardioselective β-blockers and β-blockers with vasodilatatory properties.
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How to Cite
Obremska, M. (2014). Β-blockers – all we need to know. Medycyna Faktow (J EBM), 7(2(23), 12-17. Retrieved from https://journalsmededu.pl/index.php/jebm/article/view/2360
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References
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2. Zaagsma J., Nahorski S.R.: Is the adipocyte beta-adrenoceptor a prototype for the recently cloned atypical “beta 3-adrenoceptor”? Trends. Pharmacol. Sci. 1990; 11: 3-7.
3. Dessy C., Moniotte S., Ghisdal P. et al.: Endothelial β3-Adrenoceptors Mediate Vasorelaxation of Human Coronary Microarteries Through Nitric Oxide and Endothelium-Dependent Hyperpolarization. Circulation 2004; 110: 948-954.
4. Neutel J.M., Smith D.H., Ram C.V. et al.: Application of ambulatory blood pressure monitoring in differentiating between antihypertensive agents. Am. J. Med. 1993; 94: 181-7.
5. Frishman W.H., Saunders E.: Beta-Adrenergic blockers. J. Clin. Hypertens. 2011; 13: 649-53.
6. Salpeter S., Ormiston T., Saltpeter E.: Cardioselective beta-blockers for chronic obstructive pulmonary disease. Cochrane Database Syst. Rev. 2005:CD003566.
7. Muenzel T., Gori T.: Nebivolol – the somewhat different beta-adrenergic receptor blocker. J. Am. Coll. Cardiol. 2009; 54: 1491-1499.
8. Afonso R.A., Patarrao R.S., Macedo M.P. et al.: Carvedilol action is dependent on endogenous production of nitric oxide. Am. J. Hypertens. 2006; 19: 419-25.
9. Pasini A.F., Garbin U., Stranieri C. et al.: Nebivolol treatment reduces serum levels of asymmetric dimethylarginine and improves endothelial dysfunction in essential hypertensive patients. Am. J. Hypertens. 2008; 21: 1251-7.
10. Williams B., Lacy P.S., Thom S.M. et al. Anglo-Scandinavian Cardiac Outcomes Trial Investigators; CAFE Steering Committee and Writing Committee: Differential impact of blood pressure lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006; 113: 1213-25.
11. Dhakam Z., Yasmin, McEniery C.M. et al.: A comparison of atenolol and nebivolol in isolated systolic hypertension. J. Hypertens. 2008; 26: 351-6.
12. Bakris G.: An in-depth analysis of vasodilation in the management of hypertension: focus on adrenergic blockade. J. Cardiovasc. Pharmacol. 2009; 53: 379-87.
13. Marchi F., Ciriell G.: Efficacy of carvedilol in mild to moderate essential hypertension and effects on microalbuminuria: a multicenter, randomized, open-label, controlled study versus atenolol. Adv. Ther. 1995; 12: 212-221.
14. Brixius K., Middeke M., Lichtenthal A. et al.: Nitirc oxide, erectile dysfunction and beta-blocker treatment (MR NOED study): benefit of nebivolol versus metoprolol in hypertensive men. Clin. Exp. Pharmacol. Physiol. 2007; 34: 327-31.
15. Poole- Wilson P.A., Swedberg K., Cleland J.G. et al.: Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol or Metoprolol European Trail (COMET): randomized controlled trial. Lancet 2003; 262: 7-13.
16. Bakris G.L., Fonseca V., Katholi R.E. et al.: Metabolic effects of carvedilol versus metoprolol in patiens with type 2 diabetes mellitus and hypertension: randomized controlled trial. JAMA 2004; 292: 2227-36.
17. Oliveira P.J., Bjork J.A., Santos M.S. et al.: Carvedilol-mediated antioxidant protection against doxorubicin-induced cardiac mitochondrial toxicity. Toxicol. Appl. Pharmacol. 2004; 200: 159-168.
18. Opolski G., Krzakowski M.: Postępowanie w powikłaniach sercowo-naczyniowych w raku piersi. Rekomendacje Krajowego Nadzoru Kardiologicznego i Onkologicznego dotyczące bezpieczeństwa kardiologicznego u chorych na raka piersi. Wyd. Med., Warszawa 2010: 1-232.
19. Ko D.T., Hebert P.R., Coffey C.S. et al.: Beta-blocker therapy and symptoms of depression, fatigue, and sexual dysfunction. JAMA 2002; 288: 351-7.
20. Deneer V.H., van Hemel N.M.: Is antiaritmic treatment in the elderly different? A review of the specific changes. Drugs Aging 2011; 28: 617-33.
21. Dahlof B., Sever P.S., Poulter N.R. et al.: Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial Blood Pressure Lowering Arm (ASCOT-BPLA): a multicenter randomized controlled trial. Lancet 2005; 366: 895-906.
22. Lindholm L.H., Carlberg B., Samuelsson O.: Should beta blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet 2005; 266: 1545-1553.
23. Mancia G., Fagard R., Narkiewicz K. et al.: 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J. Hypertens. 2013; 31(7): 1281-357.
24. Freemantle N., Cleland J., Young P. et al.: Beta blockade after myocardial infraction: systematic review and meta regression analysis. BMJ 1999; 318: 1730-7.