Beta-blockers in heart failure: are pharmacological differences clinically important?

Abstract:

:Beta-blockers are not an homogeneous group of agents. Only three beta-blockers, carvedilol, bisoprolol and metoprolol succinate, have had favorable effects on prognosis in controlled clinical trials in the patients with chronic heart failure. However, pharmacological differences exist between them. Metoprolol and bisoprolol are selective for beta(1)-adrenergic receptors while carvedilol blocks also beta(2)-, and alpha(1)- adrenergic receptors, and has associated antioxidant, anti-endothelin and antiproliferative properties. In COMET carvedilol was associated with a significant reduction in mortality compared to metoprolol tartrate further showing that different beta-blockers may have different effects on the outcome. These differences may be related to the ancillary properties of carvedilol or to its broader antiadrenergic profile. However, also more effective and prolonged blockade of beta1 adrenergic receptors may occur with carvedilol compared to metoprolol.

journal_name

Heart Fail Rev

journal_title

Heart failure reviews

authors

Metra M,Cas LD,di Lenarda A,Poole-Wilson P

doi

10.1023/B:HREV.0000046367.99002.a4

subject

Has Abstract

pub_date

2004-04-01 00:00:00

pages

123-30

issue

2

eissn

1382-4147

issn

1573-7322

pii

5384264

journal_volume

9

pub_type

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