Therapeutic implications of the use of selective beta‐adrenoceptor antagonists in clinical cardiology — A current review

Abstract

During the last five years of the beta‐blocker era, there has been a slow but steadily increasing interest in the clinical aspects of the selective compounds. A critical appraisal of the works published in the various fields of angina, hypertension, metabolic disorders, respiratory function, stress and exercise responses, suggests a therapeutic progress worthy of the clinician's attention.

Insulin release and carbohydrate tolerance in hyperthyroid patients during non-selective or selective β-l-adrenoceptor blockade

“…The new generation of ß-adrenoceptor blocking agents have selectivity for the ß-1-adrenoceptor and in commonly used doses leave the ß-2-receptor unopposed (Comerford 1978). It has been shown in dogs that the ß-adrenergic stimulating effect on the insulin release is mediated by ß-2-adrenoceptors (Loubatières et al 1971) and this is supported by a recent study in man (William-Olson et al 1979).…”

Electrophysiological effects of cardioselective and non‐cardioselective beta‐adrenoceptor blockers with and without ISA at rest and during exercise.

“…The clinical relevance of these properties has been widely discussed in recent years. At present, it is generally accepted that the primary effect of these substances is achieved by their specific and competitive binding at the P-adrenergic receptors thereby inhibiting the response to excess sympathetic discharge at the target organs (Clark, 1976;Comerford, 1978;Cruick-0306-5251/82/130 285-09 $01.00 shank, 1980), i.e. the clinically desired and observed effect is due to P-adrenoceptor blockade.…”

“…the clinically desired and observed effect is due to P-adrenoceptor blockade. Nevertheless, there is increasing evidence that 3-adrenoceptor blockers devoid of cardioselectivity and/or ISA may lead to the occurrence of certain cardiovascular and metabolic side effects of 18-adrenoceptor blockade (Clark, 1976;Comerford, 1978;Franz & Lohmann, 1980;Shand, 1980). In this context our present study has been performed to study the clinicoelectrophysiological profile of three commonly used 13-adrenoceptor blocking drugs, pindolol (noncardioselective, high ISA), acebutolol (cardioselective, weak ISA) and atenolol (cardioselective, no ISA), both at resting conditions as well as during ergometric exercise.…”