Current role of beta-adrenergic blockers in the management of chronic heart failure

Milton Packer

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Long-term activation of the sympathetic nervous system exerts adverse biologic effects that are mediated through α1, β1 and β2 receptors and that contribute importantly to the progression of heart failure. As a result, β blockers are no longer considered to be contraindicated for use in these patients but instead now play a critical role in the successful management of chronic heart failure. Beta blockers have been evaluated in >15,000 patients with heart failure who have participated in placebo-controlled trials. The results of these studies indicate that, like angiotensin-converting enzyme (ACE) inhibitors, long-term treatment with β blockers can lessen symptoms and improve clinical status and can reduce the risk of death as well as the combined risk of death or hospitalization. The database supporting the use of β blockers is now as persuasive (and arguably more persuasive) than the database supporting the use of ACE inhibitors in heart failure (which comprises about 7,000 patients). Yet, the benefits of β blockers are seen in patients already receiving ACE inhibitors, suggesting that combined blockade of two neurohormonal systems (renin-angiotensin system and sympathetic nervous system) can produce additive effects.

Original languageEnglish (US)
JournalAmerican Journal of Medicine
Volume110
Issue number7
StatePublished - May 7 2001

Fingerprint

Adrenergic beta-Antagonists
Heart Failure
Angiotensin-Converting Enzyme Inhibitors
Sympathetic Nervous System
Databases
Renin-Angiotensin System
Hospitalization
Placebos
Therapeutics

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Current role of beta-adrenergic blockers in the management of chronic heart failure. / Packer, Milton.

In: American Journal of Medicine, Vol. 110, No. 7, 07.05.2001.

Research output: Contribution to journalArticle

@article{f7884e34d2ef44bdade2c5a7f2bfe847,
title = "Current role of beta-adrenergic blockers in the management of chronic heart failure",
abstract = "Long-term activation of the sympathetic nervous system exerts adverse biologic effects that are mediated through α1, β1 and β2 receptors and that contribute importantly to the progression of heart failure. As a result, β blockers are no longer considered to be contraindicated for use in these patients but instead now play a critical role in the successful management of chronic heart failure. Beta blockers have been evaluated in >15,000 patients with heart failure who have participated in placebo-controlled trials. The results of these studies indicate that, like angiotensin-converting enzyme (ACE) inhibitors, long-term treatment with β blockers can lessen symptoms and improve clinical status and can reduce the risk of death as well as the combined risk of death or hospitalization. The database supporting the use of β blockers is now as persuasive (and arguably more persuasive) than the database supporting the use of ACE inhibitors in heart failure (which comprises about 7,000 patients). Yet, the benefits of β blockers are seen in patients already receiving ACE inhibitors, suggesting that combined blockade of two neurohormonal systems (renin-angiotensin system and sympathetic nervous system) can produce additive effects.",
author = "Milton Packer",
year = "2001",
month = "5",
day = "7",
language = "English (US)",
volume = "110",
journal = "American Journal of Medicine",
issn = "0002-9343",
publisher = "Elsevier Inc.",
number = "7",

}

TY - JOUR

T1 - Current role of beta-adrenergic blockers in the management of chronic heart failure

AU - Packer, Milton

PY - 2001/5/7

Y1 - 2001/5/7

N2 - Long-term activation of the sympathetic nervous system exerts adverse biologic effects that are mediated through α1, β1 and β2 receptors and that contribute importantly to the progression of heart failure. As a result, β blockers are no longer considered to be contraindicated for use in these patients but instead now play a critical role in the successful management of chronic heart failure. Beta blockers have been evaluated in >15,000 patients with heart failure who have participated in placebo-controlled trials. The results of these studies indicate that, like angiotensin-converting enzyme (ACE) inhibitors, long-term treatment with β blockers can lessen symptoms and improve clinical status and can reduce the risk of death as well as the combined risk of death or hospitalization. The database supporting the use of β blockers is now as persuasive (and arguably more persuasive) than the database supporting the use of ACE inhibitors in heart failure (which comprises about 7,000 patients). Yet, the benefits of β blockers are seen in patients already receiving ACE inhibitors, suggesting that combined blockade of two neurohormonal systems (renin-angiotensin system and sympathetic nervous system) can produce additive effects.

AB - Long-term activation of the sympathetic nervous system exerts adverse biologic effects that are mediated through α1, β1 and β2 receptors and that contribute importantly to the progression of heart failure. As a result, β blockers are no longer considered to be contraindicated for use in these patients but instead now play a critical role in the successful management of chronic heart failure. Beta blockers have been evaluated in >15,000 patients with heart failure who have participated in placebo-controlled trials. The results of these studies indicate that, like angiotensin-converting enzyme (ACE) inhibitors, long-term treatment with β blockers can lessen symptoms and improve clinical status and can reduce the risk of death as well as the combined risk of death or hospitalization. The database supporting the use of β blockers is now as persuasive (and arguably more persuasive) than the database supporting the use of ACE inhibitors in heart failure (which comprises about 7,000 patients). Yet, the benefits of β blockers are seen in patients already receiving ACE inhibitors, suggesting that combined blockade of two neurohormonal systems (renin-angiotensin system and sympathetic nervous system) can produce additive effects.

UR - http://www.scopus.com/inward/record.url?scp=0035821233&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035821233&partnerID=8YFLogxK

M3 - Article

C2 - 11334782

AN - SCOPUS:0035821233

VL - 110

JO - American Journal of Medicine

JF - American Journal of Medicine

SN - 0002-9343

IS - 7

ER -