β-blockers are not all the same: pharmacologic similarities and differences, potential combinations and clinical implications.
Stefano TaddeiNqoba TsabedzeRu-San TanPublished in: Current medical research and opinion (2024)
β-blockers are a heterogeneous class, with individual agents distinguished by selectivity for β 1 - vs. β 2 - and α-adrenoceptors, presence or absence of partial agonist activity at one of more β-receptor subtype, presence or absence of additional vasodilatory properties, and lipophilicity, which determines the ease of entry the drug into the central nervous system. Cardioselectivity (β 1 -adrenoceptor selectivity) helps to reduce the potential for adverse effects mediated by blockade of β 2 -adrenoceptors outside the myocardium, such as cold extremities, erectile dysfunction, or exacerbation of asthma or chronic obstructive pulmonary disease. According to recently updated guidelines from the European Society of Hypertension, β-blockers are included within the five major drug classes recommended as the basis of antihypertensive treatment strategies. Adding a β-blocker to another agent with a complementary mechanism may provide a rational antihypertensive combination that minimizes the adverse impact of induced sympathetic overactivity for optimal blood pressure-lowering efficacy and clinical outcomes benefit.
Keyphrases
- blood pressure
- chronic obstructive pulmonary disease
- angiotensin converting enzyme
- hypertensive patients
- lung function
- angiotensin ii
- heart rate
- drug induced
- adverse drug
- emergency department
- blood glucose
- intensive care unit
- diabetic rats
- human health
- metabolic syndrome
- skeletal muscle
- soft tissue
- oxidative stress
- botulinum toxin