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Effects of β-Blockers on Neurohormonal Activation in Patients with Congestive Heart Failure

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Abstract

The effect of β-adrenoceptor antagonists (β-blockers) on neurohormonal activation in patients with congestive heart failure has been the subject of study in numerous small clinical trials. Short term therapy with β-blockers is associated with a variable acute neurohormonal response which may be determined by the pharmacology of the agent under study and the baseline characteristics of the patient population. Long term therapy with β-blockers devoid of intrinsic sympathomimetic activity (partial agonist activity) is associated with evidence of decreased plasma markers of activation of the sympathetic nervous system, the renin-angiotensin system, and endothelin-1. β1-Selective and nonselective β-blockers appear to be associated with evidence of decreased neurohormonal activation, with differential effects on β-adrenoceptor density. Agents with partial agonist activity appear to differ from pure antagonists, with some studies reporting evidence of increased neurohormonal activation. The mechanisms by which β-blockers reduce neurohormonal activation and the clinical relevance of changes in adrenergic function to their use in the treatment of heart failure require further investigation.

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  1. Columbia Presbyterian Medical Center, Division of Circulatory Physiology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA

    David Baran, Evelyn M. Horn &  Stuart D. Katz MD

  2. Department of Internal Medicine, Warsaw Medical School, Warsaw, Poland

    Katarzyna Hryniewicz

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  1. David Baran
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  2. Evelyn M. Horn
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  4. Stuart D. Katz MD
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Baran, D., Horn, E.M., Hryniewicz, K. et al. Effects of β-Blockers on Neurohormonal Activation in Patients with Congestive Heart Failure. Drugs 60, 997–1016 (2000). https://doi.org/10.2165/00003495-200060050-00003

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