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Heart rate control with adrenergic blockade: clinical outcomes in cardiovascular medicine

David Feldman1, Terry S Elton, Doron M Menachemi

  • 1Heart Failure/Transplant and VAD Programs, Minneapolis Heart Institute, Minneapolis, Minnesota 55407, USA. dfeldman@mplsheart.com

Vascular Health and Risk Management
|June 12, 2010
PubMed

Insights

Beta-blockers effectively manage heart rate (HR) and reduce cardiovascular mortality in patients with heart failure and post-myocardial infarction. Vasodilating beta-blockers offer additional benefits for hypertension treatment.

Area of Science:

  • Cardiovascular Physiology
  • Pharmacology

Background:

  • Sympathetic nervous system (SNS) regulates heart rate (HR) and HR variability, crucial cardiovascular parameters.
  • Aberrant SNS activity, leading to elevated HR or decreased HR variability, is linked to cardiovascular diseases like heart failure, myocardial infarction, and hypertension.
  • Impaired HR control is a significant risk factor for cardiovascular morbidity and mortality.

Purpose of the Study:

  • To review the role of beta-blockers in managing HR and cardiovascular outcomes.
  • To compare the effects of traditional and vasodilating beta-blockers on HR control and metabolic parameters.
  • To highlight the importance of HR control as a treatment objective in cardiovascular conditions.

Main Methods:

  • Review of clinical studies and epidemiologic data on beta-blocker use.
  • Analysis of the mechanisms of action of beta-blockers on cell signaling and sympathetic hyperactivation.
  • Comparison of efficacy and safety profiles of traditional versus vasodilating beta-blockers.

Main Results:

  • Beta-blockers mitigate pathogenic effects of SNS hyperactivation by altering cell signaling.
  • Beta-blocker-mediated HR control improvements are associated with reduced mortality in post-infarct and heart failure patients.
  • Both traditional and vasodilating beta-blockers improve HR control in hypertension, with vasodilating agents offering benefits in peripheral vascular resistance and metabolic parameters.

Conclusions:

  • Attaining HR control is a critical treatment goal for patients with cardiovascular conditions.
  • Vasodilating beta-blockers demonstrate efficacy in improving cardiovascular outcomes and may aid in achieving HR control.
  • Further research may be warranted to establish definitive benefits of HR control in hypertension.

Keywords:
adrenergic beta-antagonistsheart failurehypertensionmyocardial infarction

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