Abstract
Objective: This review covers the pharmacokinetics and pharmacodynamic of β-blockers, the rationale for their use, some recent controversies in its use for managing hypertension, as well as, the beneficial properties of the third-generation β-blockers beyond hypertension.
Background: The efficacy and safety of β-blockers in the treatment of hypertension and other cardiovascular diseases have been established during more than 50 years of clinical experience. Recent updates of clinical guidelines have downgraded the use of β-blockers for the treatment of uncomplicated hypertension to second and third line therapy. It is a well-known fact that β-blockers exhibit heterogeneous pharmacokinetic and pharmacodynamic properties that clearly influence their clinical efficacy and tolerability in the management of essential hypertension. Conventional nonvasodilating β-blockers (atenolol and metoprolol) are inferior to first-line antihypertensive agents in terms of cardioprotection due to lower ability to reduce central blood pressure and its variability and the adverse effects on glycemic and lipid metabolism.
Conclusion: New vasodilating β-blockers, mainly carvedilol and nebivolol, show enhanced hemodynamic and metabolic properties, which probably result in a higher prevention of major cardiovascular events in hypertensive patients. Despite head-to-head clinical trials comparing the effects of vasodilating vs. nonvasodilating β-blockers on hard clinical endpoints are lacking, the current evidence suggests that third-generation β-blockers are superior to conventional β-blockers for the prevention of cardiovascular events in patients with essential hypertension. Moreover, beyond their antihypertensive properties, third-generation β-blockers also have pleiotropic, antioxidant and antiinflammatory effects that warrant a “promissory new era” of this newly group.
Keywords: β-blockers, essential hypertension, central blood pressure, pharmacokinetics, pharmacodynamics, target organ damage, glycemia, lipids.
Current Pharmaceutical Design
Title:What is the Real Efficacy of Beta-Blockers for the Treatment of Essential Hypertension?
Volume: 23 Issue: 31
Author(s): Christian Hocht*, Facundo M. Bertera, Julieta S. Del Mauro, Yanina Santander Plantamura, Carlos A. Taira and Ariel H Polizio
Affiliation:
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquimica, Departamento de Farmacologia. Buenos Aires,Argentina
Keywords: β-blockers, essential hypertension, central blood pressure, pharmacokinetics, pharmacodynamics, target organ damage, glycemia, lipids.
Abstract: Objective: This review covers the pharmacokinetics and pharmacodynamic of β-blockers, the rationale for their use, some recent controversies in its use for managing hypertension, as well as, the beneficial properties of the third-generation β-blockers beyond hypertension.
Background: The efficacy and safety of β-blockers in the treatment of hypertension and other cardiovascular diseases have been established during more than 50 years of clinical experience. Recent updates of clinical guidelines have downgraded the use of β-blockers for the treatment of uncomplicated hypertension to second and third line therapy. It is a well-known fact that β-blockers exhibit heterogeneous pharmacokinetic and pharmacodynamic properties that clearly influence their clinical efficacy and tolerability in the management of essential hypertension. Conventional nonvasodilating β-blockers (atenolol and metoprolol) are inferior to first-line antihypertensive agents in terms of cardioprotection due to lower ability to reduce central blood pressure and its variability and the adverse effects on glycemic and lipid metabolism.
Conclusion: New vasodilating β-blockers, mainly carvedilol and nebivolol, show enhanced hemodynamic and metabolic properties, which probably result in a higher prevention of major cardiovascular events in hypertensive patients. Despite head-to-head clinical trials comparing the effects of vasodilating vs. nonvasodilating β-blockers on hard clinical endpoints are lacking, the current evidence suggests that third-generation β-blockers are superior to conventional β-blockers for the prevention of cardiovascular events in patients with essential hypertension. Moreover, beyond their antihypertensive properties, third-generation β-blockers also have pleiotropic, antioxidant and antiinflammatory effects that warrant a “promissory new era” of this newly group.
Export Options
About this article
Cite this article as:
Hocht Christian *, Bertera M. Facundo , Del Mauro S. Julieta , Santander Plantamura Yanina , Taira A. Carlos and Polizio H Ariel, What is the Real Efficacy of Beta-Blockers for the Treatment of Essential Hypertension?, Current Pharmaceutical Design 2017; 23 (31) . https://dx.doi.org/10.2174/1381612823666170608085109
DOI https://dx.doi.org/10.2174/1381612823666170608085109 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Herbal Medicines for Diabetes Management and its Secondary Complications
Current Diabetes Reviews Blockade of Renin Angiotensin System in Heart Failure Post-Myocardial Infarction: What is the Best Therapy?
Recent Patents on Cardiovascular Drug Discovery Addiction Liability of Pharmacotherapeutic Interventions in Obesity
Current Pharmaceutical Design Possible Consequences of Blocking Transient Receptor Potential Vanilloid 1
Current Pharmaceutical Biotechnology Health Benefits of Honey: Implications for Treating Cardiovascular Diseases
Current Nutrition & Food Science The Promising Pharmacological Effects and Therapeutic/Medicinal Applications of Punica Granatum L. (Pomegranate) as a Functional Food in Humans and Animals
Recent Patents on Inflammation & Allergy Drug Discovery Cardioprotection Against Ischemia/Reperfusion Injury and Chromogranin ADerived Peptides
Current Medicinal Chemistry Cardiovascular Disease in Masked Hypertension: Clinical Implications
Current Hypertension Reviews Daily Living Activities and Cognition in Aged Patients: Effect of Acute Systemic Diseases and Stroke on Leukoaraiosis
Current Aging Science Can We Move Forward After ADVANCE?
Vascular Disease Prevention (Discontinued) Dissolution Enhancement of Eplerenone using Solvent Melt Method
Drug Delivery Letters The Potential Effect of Carvedilol Against Osteoporosis in Ovariectomized Rats
Current Drug Therapy Non-Invasive Assessment of Non-Alcoholic Fatty Liver Disease: Ultrasound and Transient Elastography
Reviews on Recent Clinical Trials The Relationship between Age-Related Kidney Dysfunction and Framingham Risk Score in Healthy People in China
Current Aging Science By Discontinuing Beta-Blockers Before an Exercise Test, We may Precipitate a Rebound Phenomenon
Current Vascular Pharmacology Cardiac Remodeling Induced by Smoking: Concepts, Relevance, and Potential Mechanisms
Inflammation & Allergy - Drug Targets (Discontinued) Oxidative Stress in the Pathogenesis/Treatment of Atherosclerosis
Current Nutrition & Food Science Clinical Approach to Diabetic Cardiomyopathy: A Review of Human Studies
Current Medicinal Chemistry Treatment of Hypertensive Left Ventricular Hypertrophy
Current Pharmaceutical Design The Important Role of Potatoes, An Underrated Vegetable Food Crop in Human Health and Nutrition
Current Nutrition & Food Science