Hemodynamic effects of celiprolol in essential hypertension

Fröhlich, Edward D.; Ketelhut, Reinhard G.; Kaesser, U R; Losem, Christoph; Messerli, Franz H.

doi:10.1016/0002-9149(91)90787-l

Cited by 5 publications

(2 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a result, following its immediate (intravenous) as well as long-term oral hemodynamic response produces a decreased total peripheral as well as organ vascular responses. The second agent, celiprolol, was also well studied a number of years ago [Frohlich et al 1991], but it did not receive commercial release in this country. This compound has not only the beta-1 receptor antagonistic action expected of the beta-blocker, but it is also reported to have a beta-1 agonist response which was said to be responsible for its immediate and long-term hemodynamic action of decreasing total peripheral and organ vascular responses.…”

Section: Newer Beta-adrenergic Blocking Agentsmentioning

confidence: 99%

Role of beta-adrenergic receptor blocking agents in hypertensive diseases: personal thoughts as the controversy persists

Fröhlich

2009

Therapeutic Advances in Cardiovascular Disease

Self Cite

View full text Add to dashboard Cite

The long history of the beta-adrenergic receptor blockers for the treatment of hypertension is fraught with many controversies. The first compound had severe untoward effects preventing their use until propranolol was introduced. It was found effective for treatment of angina pectoris since not all patients with hypertension responded to monotherapy with a meaningful reduction of pressure. Nevertheless, the beta-blockers were most effective in: younger patients, especially with hyperkinetic circulation; with co-morbid diseases (e.g. coronary arterial disease with or without prior myocardial infarction); or when used with a diuretic. Subsequently with the advent of meta-analysis to evaluate more generalized experience, controversy resumed with statements made to exclude beta-blockers for initial hypertensive therapy. Support for this argument was gained with reports of patients developing 'dysglycemia' with treatment. However, exclusion of any one therapeutic class for a multifactorial disease such as hypertension seems unrealistic. Meta-analysis confounded this conclusion since inadequate numbers of patients having specific clinical and biological characteristics were included (especially young patients). This is particularly important at this time when third-party reimbursement procedures are particularly relevant and when the primary care physician must deal with the individual patient. The NICE report has introduced specific thinking along these lines. In-and-of itself, its recommendations are reasonable, but current articles continue to suggest that the 'older' beta-blockers should be excluded from national guidelines for initial antihypertensive therapy. Personally, I disagree; and, no doubt, controversy will continue.

show abstract

Section: Newer Beta-adrenergic Blocking Agentsmentioning

confidence: 99%

Role of beta-adrenergic receptor blocking agents in hypertensive diseases: personal thoughts as the controversy persists

Fröhlich

2009

Therapeutic Advances in Cardiovascular Disease

Self Cite

View full text Add to dashboard Cite

show abstract

“…Most beta-blockers decrease renal vascular resistance in patients with uncomplicated essential hypertension [14]. A more recent group of beta-blockers possesses beta 1 receptor antagonistic and beta 2 receptor agonist properties (eg, celiprolol), which immediately reduces total peripheral as well as organ vascular resistances [15]. These actions, although different from an alpha-and beta-blocker (eg, labetalol), provide the same net hemodynamic effect [16].…”

Section: Beta-adrenergic and Alpha-beta Adrenergic Receptor-blocking mentioning

confidence: 99%

Hypertension

Fröhlich

2001

Curr Treat Options Cardio Med

Self Cite

View full text Add to dashboard Cite

Controlled multicenter clinical trials and almost 50 years of clinical experience have demonstrated incontrovertibly the efficacy, safety, and feasibility of antihypertensive pharmacotherapy. In addition, this vast clinical record has shown, through the intrinsic ability of antihypertensive therapy to control arterial pressure, how to prevent and reverse many of the complications of hypertensive cardiovascular disease affecting the major target organs of the disease (eg, heart, brain, and kidneys). Few questions exist as to which patients should be treated, although some controversy may still exist among authorities as to the selection of specific classes of antihypertensive therapy. Thus, it is now clear that no matter whether systolic or diastolic pressures are elevated (ie, greater than 139 mm Hg or 89 mm Hg, respectively), control of elevated pressure is indicated. One possible and provisional exception to this sweeping statement may relate to patients with borderline isolated systolic hypertension (between 140 and 159 mm Hg, with diastolic pressures less than 90 mm Hg). This discussion concerns the treatment options that are presently available and offers guidelines as to which patients with hypertension may be more suitable for the various classes of agents that are available.

show abstract