Antihypertensive and cardioprotective effects of three generations of beta-adrenergic blockers: an historical perspective

Chrysant, Steven G.; Chrysant, George S.

doi:10.1080/21548331.2022.2040920

Cited by 12 publications

(2 citation statements)

References 91 publications

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“…ß-blockers are currently not regarded first line therapy but can be considered when appropriate [ 26 , 27 ]. Even though not considered first line therapy, we made positive experiences with ß-blockers and favor them due to their cardioprotective effects [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Arterial hypertension in infants with congenital diaphragmatic hernia following surgical repair

Engel,

Leyens,

et al. 2024

Eur J Pediatr

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Pulmonary hypertension (PH) and cardiac dysfunction are established comorbidities of congenital diaphragmatic hernia (CDH). However, there is very little data focusing on arterial hypertension in CDH. This study aims to investigate the incidence of arterial hypertension in neonates with CDH at hospital discharge. Archived clinical data of 167 CDH infants who received surgical repair of the diaphragmatic defect and survived for > 60 days were retrospectively analyzed. Blood pressure (BP) values were averaged for the last 7 days before discharge and compared to standard BP values for sex, age, and height provided by the AHA in 2004. BP values reaching or extending the 95th percentile were defined as arterial hypertension. The use of antihypertensive medication was analyzed at discharge and during hospitalization. Arterial hypertension at discharge was observed in 19 of 167 infants (11.3%) of which 12 (63%) were not receiving antihypertensive medication. Eighty patients (47.9%) received antihypertensive medication at any point during hospitalization and 28.9% of 152 survivors (n = 44) received antihypertensive medication at discharge, although in 45.5% (n = 20) of patients receiving antihypertensive medication, the indication for antihypertensive medication was myocardial hypertrophy or frequency control. BP was significantly higher in ECMO compared to non-ECMO patients, despite a similar incidence of arterial hypertension in both groups (13.8% vs. 10.1%, p = 0.473). Non-isolated CDH, formula feeding, and minimal creatinine in the first week of life were significantly associated with arterial hypertension on univariate analysis. Following multivariate analysis, only minimal creatinine remained independently associated with arterial hypertension. Conclusion: This study demonstrates a moderately high incidence of arterial hypertension in CDH infants at discharge and an independent association of creatinine values with arterial hypertension. Physicians should be aware of this risk and include regular BP measurements and test of renal function in CDH care and follow-up. What is Known:• Due to decreasing mortality, morbidity is increasing in surviving CDH patients.• Pulmonary hypertension and cardiac dysfunction are well-known cardiovascular comorbidities of CDH. What is New:• There is a moderately high incidence of arterial hypertension in CDH infants at discharge even in a population with frequent treatment with antihypertensive medication.• A more complicated hospital course (ECMO, higher degree of PH, larger defect size) was associated with a higher risk for arterial hypertension.

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Section: Discussionmentioning

confidence: 99%

Arterial hypertension in infants with congenital diaphragmatic hernia following surgical repair

Engel,

Leyens,

et al. 2024

Eur J Pediatr

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“…Since then, several β-blockers have gradually replaced propranolol, mainly in cardiovascular disease. However, propranolol and its generics continue to be widely prescribed [ 61 ]. The first observations of the antitumor effects of propranolol date back to 1966 against pheochromocytoma, but it was not until 2008 when Léauté-Labrèze et al demonstrated its therapeutic utility for infantile hemangioma in 11 patients [ 62 ].…”

Section: Truly Repurposed Cancer Drugs Whose First Regulatory Labelin...mentioning

confidence: 99%

Does Therapeutic Repurposing in Cancer Meet the Expectations of Having Drugs at a Lower Price?

et al. 2023

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Therapeutic repurposing emerged as an alternative to the traditional drug discovery and development model (DDD) of new molecular entities (NMEs). It was anticipated that by being faster, safer, and cheaper, the development would result in lower-cost drugs. As defined in this work, a repurposed cancer drug is one approved by a health regulatory authority against a non-cancer indication that then gains new approval for cancer. With this definition, only three drugs are repurposed for cancer: Bacillus Calmette–Guerin (BCG) vaccine (superficial bladder cancer, thalidomide [multiple myeloma], and propranolol [infantile hemangioma]). Each of these has a different history regarding price and affordability, and it is not yet possible to generalize the impact of drug repurposing on the final price to the patient. However, the development, including the price, does not differ significantly from an NME. For the end consumer, the product’s price is unrelated to whether it followed the classical development or repurposing. Economic constraints for clinical development, and drug prescription biases for repurposing drugs, are barriers yet to be overcome. The affordability of cancer drugs is a complex issue that varies from country to country. Many alternatives for having affordable drugs have been put forward, however these measures have thus far failed and are, at best, palliative. There are no immediate solutions to the problem of access to cancer drugs. It is necessary to critically analyze the impact of the current drug development model and be creative in implementing new models that genuinely benefit society.

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Beta-Blockers and Hypertension: Some Questions and Answers

Fıcı

Robles

Tengiz

2023

High Blood Press Cardiovasc Prev

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Antihypertensive and cardioprotective effects of three generations of beta-adrenergic blockers: an historical perspective

Cited by 12 publications

References 91 publications

Arterial hypertension in infants with congenital diaphragmatic hernia following surgical repair

Arterial hypertension in infants with congenital diaphragmatic hernia following surgical repair

Does Therapeutic Repurposing in Cancer Meet the Expectations of Having Drugs at a Lower Price?

Beta-Blockers and Hypertension: Some Questions and Answers

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