β-blockers are not all the same: pharmacologic similarities and differences, potential combinations and clinical implications

• Published in: Current medical research and opinion Vol. 40; no. sup1; p. 15
• Main Authors: Taddei, Stefano, Tsabedze, Nqoba, Tan, Ru-San
• Format: Journal Article
• Language: English
• Published: England 2024
• Subjects: Adrenergic beta-Antagonists - adverse effects; Antihypertensive Agents - adverse effects; Blood Pressure; Humans; Hypertension - drug therapy; Male; heart failure; combination therapy; bisoprolol; hypertension; β-blockade
• ISSN: 1473-4877
• DOI: 10.1080/03007995.2024.2318058

β-blockers are a heterogeneous class, with individual agents distinguished by selectivity for β - vs. β - and α-adrenoceptors, presence or absence of partial agonist activity at one of more β-receptor subtype, presence or absence of additional vasodilatory properties, and lipophilicity, which determines the ease of entry the drug into the central nervous system. Cardioselectivity (β -adrenoceptor selectivity) helps to reduce the potential for adverse effects mediated by blockade of β -adrenoceptors outside the myocardium, such as cold extremities, erectile dysfunction, or exacerbation of asthma or chronic obstructive pulmonary disease. According to recently updated guidelines from the European Society of Hypertension, β-blockers are included within the five major drug classes recommended as the basis of antihypertensive treatment strategies. Adding a β-blocker to another agent with a complementary mechanism may provide a rational antihypertensive combination that minimizes the adverse impact of induced sympathetic overactivity for optimal blood pressure-lowering efficacy and clinical outcomes benefit.