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Anesthesiology Jan 2023
Topics: Humans; Perioperative Care; Adrenergic beta-Antagonists; Surgical Procedures, Operative
PubMed: 36520077
DOI: 10.1097/ALN.0000000000004441 -
British Journal of Hospital Medicine... Feb 2020The cardiovascular effects of beta blockers are widespread, so their use in the perioperative period ought to be beneficial, although this is not clear cut. This article...
The cardiovascular effects of beta blockers are widespread, so their use in the perioperative period ought to be beneficial, although this is not clear cut. This article discusses the evidence for and against the use of beta blockers perioperatively and gives guidance for best practice.
Topics: Adrenergic beta-Antagonists; Cardiovascular Diseases; Humans; Perioperative Care; Postoperative Complications; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Risk Factors
PubMed: 32097066
DOI: 10.12968/hmed.2019.0259 -
Current Opinion in Pharmacology Jun 2014β-Blockers are used for a wide range of diseases from hypertension to glaucoma. In some diseases/conditions all β-blockers are effective, while in others only certain... (Review)
Review
β-Blockers are used for a wide range of diseases from hypertension to glaucoma. In some diseases/conditions all β-blockers are effective, while in others only certain subgroups are therapeutically beneficial. The best-documented example for only a subset of β-blockers showing clinical efficacy is in heart failure, where members of the class have ranged from completely ineffective, to drugs of choice for treating the disease. Similarly, β-blockers were tested in murine asthma models and two pilot clinical studies. A different subset was found to be effective for this clinical indication. These findings call into question the current system of classifying these drugs. To consider 'β-blockers', as a single class is misleading when considering their rigorous pharmacological definition and their appropriate clinical application.
Topics: Adrenergic beta-Antagonists; Animals; Asthma; Humans; Ligands; Receptors, Adrenergic, beta-2; Signal Transduction
PubMed: 24681351
DOI: 10.1016/j.coph.2014.03.002 -
Missouri Medicine 2014
Topics: Adrenergic beta-Antagonists; Humans; Migraine Disorders
PubMed: 25438355
DOI: No ID Found -
Indian Journal of Dermatology,... 2017
Review
Topics: Adrenergic beta-Antagonists; Animals; Dermatology; Humans; Skin Diseases
PubMed: 28366914
DOI: 10.4103/ijdvl.IJDVL_220_16 -
Arquivos Brasileiros de Cardiologia Oct 2000Cardiac dysfunction in heart failure is widely recognized as a progressive process, regardless of the clinical signs and symptoms. An increase in cardiac sympathetic... (Review)
Review
Cardiac dysfunction in heart failure is widely recognized as a progressive process, regardless of the clinical signs and symptoms. An increase in cardiac sympathetic drive is one of the earliest neurohormonal responses occurring in patients with heart failure and may be one of the major causes of the progressive remodeling leading to the decline in myocardial function, and responsible for the poor prognosis of patients with heart failure. Therefore, recent data provided by several appropriately designed clinical trials clearly indicate the benefits of beta-adrenoceptor blocking agents, combined with diuretics, ACE inhibitors, and digoxin in chronic heart failure class II to IV due to systolic ventricular dysfunction. The benefits are related to symptoms, functional capacity, remodeling, and improvement in left ventricular function, reduction in cardiovascular hospitalization, a decrease in the overall and sudden cardiac death rate, and are similar in patients with ischemic or nonischemic cardiomyopathy, independent of age, gender, or functional class. In this review we describe the cardiovascular effects of the increase in sympathetic drive, the pharmacological properties of the beta-blockers most evaluated in heart failure therapy (metoprolol, bisoprolol, and carvedilol), the major clinical trials related to these agents in heart failure, the recommendations for their appropriate use in clinical practice, the precautions to be adopted, and how to handle the more common adverse reactions.
Topics: Adrenergic beta-Antagonists; Cardiac Output, Low; Humans
PubMed: 11058931
DOI: 10.1590/s0066-782x2000001000009 -
Scientific Reports Mar 2022Heart failure is a multifactorial disease that affects an estimated 38 million people worldwide. Current pharmacotherapy of heart failure with reduced ejection fraction...
Heart failure is a multifactorial disease that affects an estimated 38 million people worldwide. Current pharmacotherapy of heart failure with reduced ejection fraction (HFrEF) includes combination therapy with angiotensin-converting enzyme inhibitors (ACEi) and β-adrenergic receptor blockers (β-AR blockers), a therapy also used as treatment for non-cardiac conditions. Our knowledge of the molecular changes accompanying treatment with ACEi and β-AR blockers is limited. Here, we applied proteomics and phosphoproteomics approaches to profile the global changes in protein abundance and phosphorylation state in cardiac left ventricles consequent to combination therapy of β-AR blocker and ACE inhibitor in HFrEF and control hearts. The phosphorylation changes induced by treatment were profoundly different for failing than for non-failing hearts. HFrEF was characterized by profound downregulation of mitochondrial proteins coupled with derangement of β-adrenergic and pyruvate dehydrogenase signaling. Upon treatment, phosphorylation changes consequent to HFrEF were reversed. In control hearts, treatment mainly led to downregulation of canonical PKA signaling. The observation of divergent signaling outcomes depending on disease state underscores the importance of evaluating drug effects within the context of the specific conditions present in the recipient heart.
Topics: Adrenergic beta-Antagonists; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Heart; Heart Failure; Humans; Stroke Volume
PubMed: 35306519
DOI: 10.1038/s41598-022-08534-0 -
British Journal of Clinical Pharmacology Nov 2014β-adrenoceptor blockers have an important role in the treatment of heart disease and are useful as an adjunct in systemic hypertension. They are often prescribed at... (Review)
Review
β-adrenoceptor blockers have an important role in the treatment of heart disease and are useful as an adjunct in systemic hypertension. They are often prescribed at unnecessarily high doses, near the top of the dose-response curve. Higher doses are associated with more adverse events, have not been shown to improve clinical outcomes in cardiac failure and may worsen outcome in hypertension. β-adrenoceptor blockers can be very effective in lower doses, guided by close monitoring of heart rate and blood pressure and, when used in combination with low dose vasodilators and diuretics, give a better risk benefit profile.
Topics: Adrenergic beta-Antagonists; Blood Pressure; Clinical Trials as Topic; Dose-Response Relationship, Drug; Heart Diseases; Heart Rate; Humans; Hypertension; Practice Guidelines as Topic; Treatment Outcome
PubMed: 24912767
DOI: 10.1111/bcp.12439 -
Cardiovascular Journal of Africa 2007
Topics: Adrenergic beta-Antagonists; Humans; Hypertension; Research
PubMed: 18092107
DOI: No ID Found -
Congestive Heart Failure (Greenwich,... 2004The addition of beta-adrenergic antagonists to the treatment regimen for heart failure has validated the neurohormonal hypothesis and provided much-improved outcomes.... (Review)
Review
The addition of beta-adrenergic antagonists to the treatment regimen for heart failure has validated the neurohormonal hypothesis and provided much-improved outcomes. This benefit had been in question for African Americans based on past experiences in the field of hypertension and worrisome data reported from the Beta Blocker Evaluation of Survival Trial. However, the totality of data now demonstrate that African Americans respond favorably to beta blockers and are capable of having the same outcomes in response to medical therapy for heart failure. There should be no reluctance, nor is there an appropriate rationale, to withhold beta-blocker therapy for heart failure to any patient with left ventricular dysfunction without an overt contraindication. The first prospective trial in African Americans with heart failure, the African American Heart Failure Trial (A-HeFT), is ongoing and provides additional insight into the best treatment strategies for this patient population.
Topics: Adrenergic beta-Antagonists; Black or African American; Heart Failure; Heart Ventricles; Humans; Randomized Controlled Trials as Topic; United States; Ventricular Dysfunction, Left
PubMed: 14872156
DOI: 10.1111/j.1527-5299.2004.02024.x