Keywords
Cardiology
Treatment
Mechanism of action
Medication
How to Cite
Abstract
Introduction: Beta-blockers (BB) are a class of medications known for their effects on cardiovascular conditions, such as acute myocardial infarction, heart failure, hypertension, and arrhythmias. Their history has made evident the necessity of their use in the treatment of heart diseases, making them one of the most commonly used classes in clinical practice. Objective: This study aims to analyze the documented updates regarding beta-blockers, as well as their mechanisms and main uses in clinical practice. Methodology: The study conducted a literature review using Google Scholar and PubMed. Articles published in both Portuguese and English were included. Inclusion criteria required that studies focus on the therapeutic use of beta-blockers or their mechanisms of action. Results: Beta-blockers are drugs whose mechanism can be described as antagonists of beta-adrenergic receptors, thereby triggering effects such as bradycardia and increased cardiac filling time. They are subclassified into three major groups: The first generation, with propranolol as the main representative, which has a high affinity for both beta-1 and beta-2 adrenergic receptors, and therefore, they exhibit adverse effects such as bronchoconstriction and vasoconstriction. The second generation, with atenolol and metoprolol as the main representatives, has a higher affinity for beta-1 receptors over beta-2 receptors, thus producing fewer extracardiac effects. Lastly, the third generation includes drugs like carvedilol, which block alpha-1 receptors and cause vasodilation. Due to these mechanisms, beta-blockers are used as therapy for various cardiovascular conditions such as heart failure, hypertension, and myocardial infarction. Conclusion: The diverse use of beta-blockers is largely due to the range of medications that make up this class, providing a myriad of options for clinical practice. Therefore, the importance of beta-blockers in clinical practice is evident, serving as a cornerstone in the treatment of various conditions.
References
BAKER, Jillian G.; HILL, Stephen J.; SUMMERS, Roger J. Evolution of β-blockers: From anti-anginal drugs to ligand-directed signalling. Trends in Pharmacological Sciences, [s. l.], v. 32, n. 4, p. 227–234, 2011. Disponível em: http://dx.doi.org/10.1016/j.tips.2011.02.010.
BANGALORE, Sripal et al. Clinical outcomes with β-blockers for myocardial infarction: A meta-analysis of randomized trials. American Journal of Medicine, [s. l.], v. 127, n. 10, p. 939–953, 2014. Disponível em: http://dx.doi.org/10.1016/j.amjmed.2014.05.032.
BARRETT, A. M. et al. A new type of cardioselective adrenoceptive blocking drug. Brit.J.Pharmacol., [s. l.], v. 48, n. 2, p. 66082, 1973.
DAVIDSON, Sean M. et al. Multitarget Strategies to Reduce Myocardial Ischemia/Reperfusion Injury: JACC Review Topic of the Week. Journal of the American College of Cardiology, [s. l.], v. 73, n. 1, p. 89–99, 2019.
DE LIMA, Luiz Gustavo et al. Beta-blockers for preventing stroke recurrence. Cochrane Database of Systematic Reviews, [s. l.], v. 2014, n. 10, 2014.
DO VALE, Gabriel T. et al. Three Generations of β-blockers: History, Class Differences and Clinical Applicability. Current Hypertension Reviews, [s. l.], v. 15, n. 1, p. 22–31, 2018.
FLACCO, N. et al. Different β-adrenoceptor subtypes coupling to cAMP or NO/cGMP pathways: Implications in the relaxant response of rat conductance and resistance vessels. British Journal of Pharmacology, [s. l.], v. 169, n. 2, p. 413–425, 2013.
FLATHER, Marcus D. et al. FASTTRACK Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). European Heart Journal, [s. l.], v. 26, n. 3, p. 215–225, 2005.
FREEMANTLE, Nick et al. β blockade after myocardial infarction: Systematic review and meta regression analysis. British Medical Journal, [s. l.], v. 318, n. 7200, p. 1730–1737, 1999.
HEBB, A. R.; GODWIN, T. F.; GUNN, R. W. A new beta adrenergic blocking agent, propranolol, in the treatment of angina pectoris. Canadian Medical Association journal, [s. l.], v. 98, n. 5, p. 246–251, 1968.
MARTÍNEZ-MILLA, Juan et al. Role of Beta-blockers in Cardiovascular Disease in 2019. Revista Española de Cardiología (English Edition), [s. l.], v. 72, n. 10, p. 844–852, 2019.
MIZZACI, Carolina Christianini; RIEIRA, Rachel; MARTIMBIANCO, Ana Luiza Cabrera. Tratamento farmacológico para insuficiência cardíaca sistólica crônica e as evidências disponíveis: uma revisão narrativa da literatura. Diagn. tratamento, [s. l.], v. 22, n. 1, p. 8–20, 2017. Disponível em: https://docs.bvsalud.org/biblioref/2017/03/832425/rdt_v22n1_8-20.pdf.
PEDERSEN, Michala E.; COCKCROFT, John R. The vasodilatory beta-blockers. Current Hypertension Reports, [s. l.], v. 9, n. 4, p. 269–277, 2007.
POIRIER, Luc; TOBE, Sheldon W. Contemporary use of β-blockers: Clinical relevance of subclassification. Canadian Journal of Cardiology, [s. l.], v. 30, n. 5 S, p. 9–15, 2014.
WILLIANS, Bryan et al. European Society of Cardiology (ESC) Guidelines for the Management of Arterial Hypertension. [S. l.: s. n.], 2018-. ISSN 02636352.v. 339
WIYSONGE, C S et al. Beta-blockers for hypertension. Cochrane Database of Systematic Reviews, [s. l.], v. 11, n. 8, p. CD002003, 2017.
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