Document Detail


The vasodilatory beta-blockers.
MedLine Citation:
PMID:  17686376     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although well established in treating hypertension and cardiovascular (CV) disease, clinical trial data suggest that beta-blockers (eg, atenolol) may be less effective than other antihypertensive classes in reducing stroke and CV mortality despite similar blood pressure (BP) reductions. One possible explanation is that atenolol is less effective in reducing central aortic pressure. Newer vasodilating beta-blockers may prove more effective in reducing central pressure and cardiovascular events. Carvedilol and labetalol appear to cause vasodilation through alpha(1)-receptor blockade; nebivolol induces endothelium-dependent vasodilation by stimulating nitric oxide bioactivity. Their favorable hemodynamic profile includes reduction of peripheral vascular resistance (PVR) while maintaining or improving cardiac output (CO), stroke volume, and left ventricular function, whereas nonvasodilating beta-blockers tend to raise PVR and reduce CO and left ventricular function. Compared with conventional beta-blockers, vasodilating beta-blockers have beneficial hemodynamic effects including decreased pressure wave reflection from the periphery, leading to decreases in central aortic blood pressure. Larger trials are needed to determine whether reduced central pressure will translate into improved CV outcomes compared with nonvasodilating beta-blockers.
Authors:
Michala E Pedersen; John R Cockcroft
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current hypertension reports     Volume:  9     ISSN:  1522-6417     ISO Abbreviation:  Curr. Hypertens. Rep.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-09     Completed Date:  2008-03-21     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  100888982     Medline TA:  Curr Hypertens Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  269-77     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Wales Heart Research Institute, Cardiff University, Heath Park, Cardiff CF14 4XN, UK.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / adverse effects,  pharmacology*,  therapeutic use*
Antihypertensive Agents / pharmacology,  therapeutic use
Antioxidants / pharmacology,  therapeutic use
Atenolol / pharmacology,  therapeutic use
Benzopyrans / pharmacology,  therapeutic use
Blood Pressure / drug effects
Carbazoles / pharmacology,  therapeutic use
Cardiac Output / drug effects
Cardiovascular Diseases / physiopathology,  prevention & control
Endothelium, Vascular / drug effects*
Ethanolamines / pharmacology,  therapeutic use
Hemodynamics / drug effects*
Humans
Labetalol / pharmacology,  therapeutic use
Propanolamines / pharmacology,  therapeutic use
Vascular Resistance / drug effects
Vasodilation / drug effects*
Ventricular Function, Left / drug effects
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Antihypertensive Agents; 0/Antioxidants; 0/Benzopyrans; 0/Carbazoles; 0/Ethanolamines; 0/Propanolamines; 030Y90569U/nebivolol; 0K47UL67F2/carvedilol; 29122-68-7/Atenolol; 36894-69-6/Labetalol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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