Redefining beta-blocker use in hypertension: selecting the right beta-blocker and the right patient

Mann, Samuel J.

doi:10.1016/j.jash.2016.11.007

Cited by 33 publications

(29 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Administration is effective over 24 hours with a trough‐to‐peak ratio of 89% . It was hypothesized that the inferior outcome from BAAs in earlier clinical trials might have been related to the short duration of action of BAAs such as atenolol . Nebivolol, with its extended half‐life, could possibly affect the outcome and additionally contribute to increased patient adherence, since the drug is administered less frequently.…”

Section: Methodsmentioning

confidence: 99%

Nebivolol in the treatment of arterial hypertension

Olawi

Krüger

Grimm

et al. 2019

Basic Clin Pharma Tox

View full text Add to dashboard Cite

This MiniReview reports the current knowledge about the treatment of arterial hypertension with the third‐generation beta‐adrenoceptor antagonist (BAA) nebivolol. Furthermore, it reviews the advantages of nebivolol compared to the earlier generation of BAAs with respect to their different pharmacological properties. Beta‐adrenoceptor antagonists are a class of drugs applied for several different conditions, including hypertension and heart failure. They differ significantly in their pharmacological properties, including varying β1/β2‐selectivity and/or exertion of additive effects on the heart and circulation. Although these drugs have been a part of hypertensive therapy for about 40 years, the outcome of large clinical trials has put the role of BAAs into question. However, most of these results were based on first‐ and second‐generation BAAs and cannot be translated directly into third‐generation drugs. The third‐generation BAA nebivolol has the highest β1‐selectivity seen so far, together with additional vasodilating and anti‐oxidative properties. It is currently applied in the treatment of hypertension and congestive heart failure. Nebivolol has a unique pharmacological profile, despite showing similar blood pressure‐lowering effects, and has certain advantages in the treatment of hypertension compared to the previous generations of BAAs. This includes significant improvements in endothelial dysfunction, central haemodynamics and the degree of erectile dysfunction in men, a neutral/beneficial metabolic profile and lastly a more favourable side effect profile. It is widely beneficial for, for example, sexually active men and patients with comorbidities such as type II diabetes mellitus, metabolic syndrome and chronic obstructive lung disorders. Whether the advantages translate to an improved long‐term clinical outcome remains to be clarified, and ongoing prospective studies will show this in the future.

show abstract

Section: Methodsmentioning

confidence: 99%

Nebivolol in the treatment of arterial hypertension

Olawi

Krüger

Grimm

et al. 2019

Basic Clin Pharma Tox

View full text Add to dashboard Cite

show abstract

“…6 A few studies now suggest that therapeutic recommendations have gone "too far," and that β-blockers may be overlooked and unnecessarily neglected. 7 The incidence of hypertension rises with age, affecting half the population older than 65 years and reaching as many as 91% of people in their eighth decade. 8 Consequently, conscientious doctors observing practice guidelines will have taken an enormous number of people off β-blockers, or no longer prescribe them as first-line therapy.…”

Section: Guideline Impactmentioning

confidence: 99%

Do practice guidelines cause drug shortages? The historical example of β-blockers

Duffin

2019

CMAJ

View full text Add to dashboard Cite

“…The reduction in force of myocardial contraction and heart rate results in a decreased cardiac output and therefore a reduction in arterial blood pressure. Beta blockers alter baroreceptor reflex sensitivity, and reduce β1 mediated renin release from the kidneys (Mann 2017). Reduced renin leads to a reduction in angiotension II and aldosterone, which in turn enhances renal sodium and water loss and lowers blood pressure.…”

Section: Hypertensionmentioning

confidence: 99%

Beta-blocker use in cardiovascular disease

Bain

2018

British Journal of Cardiac Nursing

View full text Add to dashboard Cite

Beta-blockers are widely used to treat a number of cardiovascular diseases, including heart failure, myocardial infarction, atrial fibrillation, angina and hypertension. By inhibiting the binding of catacholamines to beta receptors in the heart and vasculature, beta-blockers can reduce cardiac contractility, heart rate, blood pressure and cardiac output. A sound understanding of how beta-blockers work and the basis of their recommendation for various indications is needed to promote their safe and effective use in patients. This article briefly describes the physiology of beta-adrenergic receptors, the mechanism of action of beta-blockers and their place in the therapy of cardiovascular disease,

show abstract

Redefining beta-blocker use in hypertension: selecting the right beta-blocker and the right patient

Cited by 33 publications

References 92 publications

Nebivolol in the treatment of arterial hypertension

Nebivolol in the treatment of arterial hypertension

Do practice guidelines cause drug shortages? The historical example of β-blockers

Beta-blocker use in cardiovascular disease

Contact Info

Product

Resources

About