Global InformationBeta blocker information
| Beta blockers | |
|---|---|
| Drug class | |
 Skeletal formula of propranolol, the first clinically successful beta blocker. | |
| Class identifiers | |
| Synonyms | beta-blockers, β-blockers, beta-adrenergic blocking agents, beta antagonists, beta-adrenergic antagonists, beta-adrenoreceptor antagonists, beta adrenergic receptor antagonists, BB |
| Use | Hypertension, arrhythmia, etc. |
| ATC code | C07 |
| Biological target | beta receptors |
| Clinical data | |
| Drugs.com | Drug Classes |
| Consumer Reports | Best Buy Drugs |
| WebMD | MedicineNet RxList |
| External links | |
| MeSH | D000319 |
| Legal status | |
| In Wikidata | |
Beta blockers, also spelled β-blockers, are a class of medications that are predominantly used to manage abnormal heart rhythms (arrhythmia), and to protect the heart from a second heart attack after a first heart attack (secondary prevention).[1] They are also widely used to treat high blood pressure, although they are no longer the first choice for initial treatment of most patients.[2]
Beta blockers are competitive antagonists that block the receptor sites for the endogenous catecholamines epinephrine (adrenaline) and norepinephrine (noradrenaline) on adrenergic beta receptors, of the sympathetic nervous system, which mediates the fight-or-flight response.[3]: 152 [4] Some block activation of all types of β-adrenergic receptors and others are selective for one of the three known types of beta receptors, designated β1, β2 and β3 receptors.[3]: 153 β1-adrenergic receptors are located mainly in the heart and in the kidneys.[4] β2-adrenergic receptors are located mainly in the lungs, gastrointestinal tract, liver, uterus, vascular smooth muscle, and skeletal muscle.[4] β3-adrenergic receptors are located in fat cells.[5]
Beta receptors are found on cells of the heart muscles, smooth muscles, airways, arteries, kidneys, and other tissues that are part of the sympathetic nervous system and lead to stress responses, especially when they are stimulated by epinephrine (adrenaline). Beta blockers interfere with the binding to the receptor of epinephrine and other stress hormones and weaken the effects of stress hormones.
In 1964, James Black[6] synthesized the first clinically significant beta blockers—propranolol and pronethalol; it revolutionized the medical management of angina pectoris[7] and is considered by many to be one of the most important contributions to clinical medicine and pharmacology of the 20th century.[8]
For the treatment of primary hypertension, meta-analyses of studies which mostly used atenolol have shown that although beta blockers are more effective than placebo in preventing stroke and total cardiovascular events, they are not as effective as diuretics, medications inhibiting the renin–angiotensin system (e.g., ACE inhibitors), or calcium channel blockers.[9][10][11][12]
- ^ Freemantle N, Cleland J, Young P, Mason J, Harrison J (June 1999). "beta Blockade after myocardial infarction: systematic review and meta regression analysis". BMJ. 318 (7200): 1730–1737. doi:10.1136/bmj.318.7200.1730. PMC 31101. PMID 10381708.
- ^ James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. (February 2014). "2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8)". JAMA. 311 (5): 507–520. doi:10.1001/jama.2013.284427. PMID 24352797.
- ^ a b Frishman WH, Cheng-Lai A, Nawarskas J, eds. (2005). "Beta-Adrenergic Blockers". Current Cardiovascular Drugs. Current Science Group. ISBN 978-1-57340-221-7. Retrieved September 7, 2010.
- ^ a b c Barranger K, Vivian E, Peterson AM (2006). "Hypertension". In Arcangelo VP, Peterson AM (eds.). Pharmacotherapeutics for advanced practice: a practical approach. Lippincott Williams & Wilkins. p. 205. ISBN 978-0-7817-5784-3. Retrieved September 7, 2010.
- ^ Clément K, Vaisse C, Manning BS, Basdevant A, Guy-Grand B, Ruiz J, et al. (August 1995). "Genetic variation in the beta 3-adrenergic receptor and an increased capacity to gain weight in patients with morbid obesity". The New England Journal of Medicine. 333 (6): 352–354. doi:10.1056/NEJM199508103330605. PMID 7609752.
- ^ "Sir James Black, OM". The Telegraph. March 23, 2010. Archived from the original on March 27, 2010. Retrieved March 25, 2010.
- ^ van der Vring JA, Daniëls MC, Holwerda NJ, Withagen PJ, Schelling A, Cleophas TJ, Hendriks MG (June 1999). "Combination of calcium channel blockers and beta blockers for patients with exercise-induced angina pectoris: a double-blind parallel-group comparison of different classes of calcium channel blockers. The Netherlands Working Group on Cardiovascular Research (WCN)". Angiology. 50 (6): 447–454. doi:10.1177/000331979905000602. PMID 10378820. S2CID 21885509.
- ^ Stapleton MP (1997). "Sir James Black and propranolol. The role of the basic sciences in the history of cardiovascular pharmacology". Texas Heart Institute Journal. 24 (4): 336–342. PMC 325477. PMID 9456487.
- ^ Wiysonge CS, Bradley HA, Volmink J, Mayosi BM, Opie LH (January 2017). "Beta-blockers for hypertension". The Cochrane Database of Systematic Reviews. 1 (1): CD002003. doi:10.1002/14651858.CD002003.pub5. PMC 5369873. PMID 28107561.
- ^ Reinhart, Marcia; Puil, Lorri; Salzwedel, Douglas M.; Wright, James M. (July 13, 2023). "First-line diuretics versus other classes of antihypertensive drugs for hypertension". The Cochrane Database of Systematic Reviews. 2023 (7): CD008161. doi:10.1002/14651858.CD008161.pub3. ISSN 1469-493X. PMC 10339786. PMID 37439548.
- ^ Zhu J, Chen N, Zhou M, Guo J, Zhu C, Zhou J, et al. (January 2022). "Calcium channel blockers versus other classes of drugs for hypertension". The Cochrane Database of Systematic Reviews. 1 (1): CD003654. doi:10.1002/14651858.CD003654.pub6. PMC 8742884. PMID 35000192.
- ^ Wiysonge CS, Bradley HA, Volmink J, Mayosi BM, Opie LH (January 2017). "Beta-blockers for hypertension". The Cochrane Database of Systematic Reviews. 1 (1): CD002003. doi:10.1002/14651858.cd002003.pub5. PMC 5369873. PMID 28107561.