The role of vasodilating beta-blockers in patients with complicated hypertension: focus on nebivolol.
Summary of "The role of vasodilating beta-blockers in patients with complicated hypertension: focus on nebivolol."
Despite their proven mortality and morbidity outcomes benefits, beta-blockers remain substantially underused in patients with cardiac conditions. Reluctance to prescribe beta-blockers may be owing to concerns about tolerability with the traditional drugs in this class. Beta-blockers with vasodilatory properties, such as carvedilol and nebivolol, may overcome the tolerability and metabolic issues associated with traditional beta-blockers. Because endothelial dysfunction, the pathophysiologic hallmark of hypertension, may be heightened in populations with difficult-to-treat hypertension (e.g., elderly patients, African American patients), a vasodilating beta-blocker may be a particularly appropriate choice for these patient groups.
Affiliation
Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA. tgiles4@cox.net
Journal Details
This article was published in the following journal.
Name: The American journal of medicine
ISSN: 1555-7162
Pages: S16-20
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20609694
- DOI: http://dx.doi.org/10.1016/j.amjmed.2010.04.014
Medical and Biotech [MESH] Definitions
Antihypertensive Agents
Drugs used in the treatment of acute or chronic vascular HYPERTENSION regardless of pharmacological mechanism. Among the antihypertensive agents are DIURETICS; (especially DIURETICS, THIAZIDE); ADRENERGIC BETA-ANTAGONISTS; ADRENERGIC ALPHA-ANTAGONISTS; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; CALCIUM CHANNEL BLOCKERS; GANGLIONIC BLOCKERS; and VASODILATOR AGENTS.
Angiotensin Ii
An octapeptide that is a potent but labile vasoconstrictor. It is produced from angiotensin I after the removal of two amino acids at the C-terminal by ANGIOTENSIN CONVERTING ENZYME. The amino acid in position 5 varies in different species. To block VASOCONSTRICTION and HYPERTENSION effect of angiotensin II, patients are often treated with ACE INHIBITORS or with ANGIOTENSIN II TYPE 1 RECEPTOR BLOCKERS.
Enoximone
1,3-Dihydro-4-methyl-5-(4-(methylthio)benzoyl)-2H-imidazol-2-one. A selective phosphodiesterase inhibitor with vasodilating and positive inotropic activity that does not cause changes in myocardial oxygen consumption. It is used in patients with congestive heart failure.
Adrenergic Beta-antagonists
Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic beta-antagonists are used for treatment of hypertension, cardiac arrhythmias, angina pectoris, glaucoma, migraine headaches, and anxiety.
Mecamylamine
A nicotinic antagonist that is well absorbed from the gastrointestinal tract and crosses the blood-brain barrier. Mecamylamine has been used as a ganglionic blocker in treating hypertension, but, like most ganglionic blockers, is more often used now as a research tool.
PubMed Articles
Beta-blockers have played a key role in the management of hypertension-related cardiovascular disease for decades, and continue to be recommended as a mainstay of therapy in national guidelines statem...
Although beta-blockers have been endorsed by guidelines committees for the treatment of patients with hypertension, particularly those with significant CVD and high CVD risk, there are concerns about...
Beta-blockers in hypertension.
Beta blockers have been used in the treatment of cardiovascular conditions for decades. Despite a long history and status as a guideline-recommended treatment option for hypertension, recent meta-anal...
In the United States, a vast segment of the adult population is classified as having the cardiometabolic syndrome, and currently there are epidemic rates of both type 2 diabetes mellitus and obesity....
Current Place of Beta-Blockers in the Treatment of Hypertension.
Hypertension represents the most common cardiovascular risk factor, affecting more than 25% of the adult population in developed societies. Although beta-blockers have been previously shown to effecti...
Clinical Trials
Nebivolol Versus Metoprolol: Comparative Effects on Fatigue and Quality of Life
Beta-blockers are prescribed to millions of people for treatment of hypertension. Fatigue is a recognized and common side effect of beta-blockers that can have significant effects on quali...
Several large trials have shown that beta-blocker treatment reduces the risk of death and hospital admission in patients with symptomatic heart failure. Unfortunately, survey data suggest...
Prophylaxis to Reduce Postoperative Atrial Fibrillation in Cardiac Surgery
Atrial Fibrillation (AF) is a common postoperative complication of cardiac surgery, occuring in approximately 25-30% of coronary artery bypass graft (CABG) patients and 35-40% of heart val...
Beta Blockers for the Treatment of Asthma
Current asthma medicines include inhalers. A common inhaler used in asthma is called a beta-agonist (for example salbutamol). They improve asthma symptoms by stimulating areas in the human...
Beta-Blocker in Chronic Obstructive Pulmonary Disease (COPD) Study
Smoking causes both smoking related lung disease (COPD) and ischaemic heart disease. These are very common conditions and many patients have both diseases. Beta-blocker drugs are extensi...
