• Adam Schneeweiss
  • Gotthard Schettler
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 72)


Propranolol is the first beta-adrenoreceptor blocker introduced to clinical use that is still routinely used today. Moreover, at present, it is the most widely used beta-adrenoreceptor in the world. It is a nonselective beta-blocker, affecting both beta-1 and beta-2 adrenoreceptors. The potency of this effect serves as a standard against which newer beta-blockers are compared. Propranolol had local anesthetic activity (membrane-stabilizing or quinidine-like effect). It is devoid of intrinsic sympathomimetic activity.


Angina Pectoris Plasma Renin Activity Sinus Node Coronary Spasm Intrinsic Sympathomimetic Activity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Lake C, et al: Use of plasma norepinephrine for evaluation of sympathetic neuronal function in man. I. Science 18:1315, 1976.Google Scholar
  2. 2.
    Ledingham JGG, et al: The meaning of aldosteronism in hypertensive disease. Circ Res [Suppl 2] 21:177, 1967.Google Scholar
  3. 3.
    Thadani U, et al: Comparison of adrenergic beta-receptor antagonists in angina pectoris. Br Med J 1:138, 1973.PubMedCrossRefGoogle Scholar
  4. 4.
    Davidson C, et al: Comparison of antihypertensive activity of beta-blocking drugs during chronic treatment. Br Med J 2:7, 1976.PubMedCrossRefGoogle Scholar
  5. 5.
    Milne JR, et al: Effect of intravenous propranolol on QT interval: a new method of assessment. Br Heart J 43:1, 1980.PubMedCrossRefGoogle Scholar
  6. 6.
    Sonnenblick EH, et al: Effect of exercise on myocardial force-velocity relations in intact unanesthetized man: relative roles of changes in heart rate, sympathetic activity, and ventricular dimensions. J Clin Invest 44:2051, 1965.PubMedCrossRefGoogle Scholar
  7. 7.
    Friedman MJ, et al: Effects of propranolol on resting and postextrasystolic potentiated left ventricular function in patients with coronary artery disease. Am Heart J 106:81, 1983.CrossRefGoogle Scholar
  8. 8.
    Port S, et al: Effects of propranolol on left ventricular function in normal men. Circulation 61:358, 1980.PubMedGoogle Scholar
  9. 9.
    Sklar J, et al: The effects of a cardioloselective (metoprolol) and a nonselective (propranolol) beta-adrenergic blocker on the response to dynamic exercise in normal men. Circulation 65:894, 1982.PubMedCrossRefGoogle Scholar
  10. 10.
    Le Winter M, et al: Effects of oral propranolol in normal subjects. Clin Pharmacol Ther 17:709, 1975.Google Scholar
  11. 11.
    Sapru RP, et al: Effect of isoprenaline and propranolol on left ventricular function as determined by nuclear angiography. Br Heart J 44:75, 1980.PubMedCrossRefGoogle Scholar
  12. 12.
    Reduto LA, et al: Radionuclide assessment of ventricular performance during propranolol withdrawal prior to aortocoronary bypass surgery. Am Heart J 96:714, 1978.PubMedCrossRefGoogle Scholar
  13. 13.
    Marshall RC, et al: Effect of oral propranolol on rest, exercise and postexercise left ventricular performance in normal subjects and patients with coronary artery disease. Circulation 63:572, 1981.PubMedCrossRefGoogle Scholar
  14. 14.
    Dwyer EM Jr, et al: Effects of beta-adrenergic blockade on left ventricular hemodynamics and the electrocardiogram during exercise-induced angina pectoris. Circulation 38:250, 1968.PubMedGoogle Scholar
  15. 15.
    Bonow, et al: Effects of verapamil and propranolol on left ventricular systolic function and diastolic filling in patients with coronary artery disease. Circulation 65:1337, 1982.PubMedCrossRefGoogle Scholar
  16. 16.
    Lake CR, et al: Adjusted plasma norepinephrine levels are similar in normotensive and hypertensive subjects. N Engl J Med 296:208, 1977.PubMedCrossRefGoogle Scholar
  17. 17.
    Sever PS, et al: Plasma-noradrenaline in essential hypertension. Lancet 1:1078, 1977.PubMedGoogle Scholar
  18. 18.
    Schocken D, Roth G: Reduced beta-adrenergic receptor concentrations in aging man. Nature 267:856, 1977.PubMedCrossRefGoogle Scholar
  19. 19.
    Vestal RE, et al: Reduced beta-adrenoreceptor sensitivity in the elderly [abstr]. Clin Res 26:488A, 1978.Google Scholar
  20. 20.
    Conway J, et al: Sympathetic nervous activity during exercise in relation to age. Cardiovasc Res 5:577, 1971.PubMedCrossRefGoogle Scholar
  21. 21.
    ß-blocker Heart Attack Trial Research Group: A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. JAMA 247:1707, 1982.CrossRefGoogle Scholar
  22. 22.
    Baber NS, et al: Multicentre post-infarction trial of propranolol in 49 hospitals in the United Kingdom, Italy and Yugoslavia. Br Heart J 44:96, 1980.PubMedCrossRefGoogle Scholar
  23. 23.
    Andersen MP, et al: Effect of alprenolol on mortality among patients with definite or suspected acute myocrdial infarction: preliminary results. Lancet 2:865, 1979.PubMedCrossRefGoogle Scholar
  24. 24.
    Keelan P: Double-blind trial of propranolol (Inderal) in angina pectoris. Br Med 1:897, 1965.CrossRefGoogle Scholar
  25. 25.
    Wolfson S, et al: Propranolol and angina pectoris. Am J Cardiol 18:345, 1966.PubMedCrossRefGoogle Scholar
  26. 26.
    Amsterdam EA, et al: Evaluation of long term use of propranolol in angina pectoris. JAMA 201:103, 1969.CrossRefGoogle Scholar
  27. 27.
    Gillam PMS, Prichard BNC: Use of propranolol in angina pectoris. Br Med J 2:337, 1965.PubMedCrossRefGoogle Scholar
  28. 28.
    Srivastava SC, et al: Double-blind trial of propranolol (Inderal) in angina of effort. Br Med J 2:724, 1964.PubMedCrossRefGoogle Scholar
  29. 29.
    Zeft HJ, et al: The effect of propranolol in the long-term treatment of angina pectoris. Arch Intern Med 124:578, 1969.PubMedCrossRefGoogle Scholar
  30. 30.
    Guazzi M, et al: Clinical electrocardiographic and hemodynamic effects of long-term use of propranolol in Prinzmetal’s variant angina pectoris. Br Heart J 1971, 33:889.PubMedCrossRefGoogle Scholar
  31. 31.
    Guazzi M, et al: Treatment of spontaneous angina pectoris with beta-blocking agents: a clinical, electrocardiographic and hemodynamic appraisal. Br Heart J 37:1235, 1975.PubMedCrossRefGoogle Scholar
  32. 32.
    Fauchier JP, et al: Amiodarone injectable et par voie orale dans le traitment de l’angor de Prinzmetal severe et syncopal. Ann Cardiol Angeiol (Paris) 27:193, 1978.Google Scholar
  33. 33.
    Robertson RM, et al: Exacerbation of vasotonic angina pectoris by propranolol. Circulation 65:281, 1982.PubMedCrossRefGoogle Scholar
  34. 34.
    Tilmant PY, et al: Detrimental effect of propranolol in patients with coronary arterial spasm countered by combination with diltiazem. Am J Cardiol 52:230, 1983.PubMedCrossRefGoogle Scholar
  35. 35.
    Kern MJ, et al: Potentiation of coronary vasconstriction by beta-adrenergic blockade in patients with coronary artery disease. Circulation 67:1178, 1983.PubMedCrossRefGoogle Scholar
  36. 36.
    Jackson M, et al: Propranolol in the treatment of essential hypertension. JAMA 237:2303, 1977.CrossRefGoogle Scholar
  37. 37.
    Prichard BNC: Propranolol as an antihypertensive agent. Am Heart J 79:128, 1970.PubMedCrossRefGoogle Scholar
  38. 38.
    Frohlich ED, et al: The paradox of beta-adrenergic blockade in hypertension. Circulation 37:417, 1968.PubMedGoogle Scholar
  39. 39.
    Offerhaus L, Van Zweiten PA: Comparative studies on central factors contributing to the hypotensive action of propranolol, alprenolol and their enantiomers. Cardiovasc Res 8:488, 1974.PubMedCrossRefGoogle Scholar
  40. 40.
    Bühler FR, et al: Propranolol inhibition of renin secretion: a specific approach to diagnosis and treatment of renin-dependent hypertensive diseases. N Engl J Med 287:1209, 1972.PubMedCrossRefGoogle Scholar
  41. 41.
    Prichard BNC, Gillam PMS: Treatment of hypertension with propranolol. Br Med J 1:7, 1969.PubMedCrossRefGoogle Scholar
  42. 42.
    Prichard BNC, Gillam PMS: Propranolol in hypertension. Am J Cardiol 18:387, 1966.PubMedCrossRefGoogle Scholar
  43. 43.
    Bravo EL, et al: ß-adrenergic blockade in diuretic-treated patients with essential hypertension. N Engl J Med 292:66, 1975.PubMedCrossRefGoogle Scholar
  44. 44.
    Hollifield JW, et al: Proposed mechanisms of propranolol’s antihypertensive effect in essential hypertension. N Engl J Med 295:68, 1976.PubMedCrossRefGoogle Scholar
  45. 45.
    VandenBurg MJ, et al: Reduced peripheral vascular symptoms in elderly patients treated with α-methyldopa: a comparison with propranolol. Eur J Clin Pharmacol 26:325, 1984.PubMedCrossRefGoogle Scholar
  46. 46.
    Sloman G: Propranolol in management of muscular subaortic stenosis. Br Heart J 29:783, 1967.PubMedCrossRefGoogle Scholar
  47. 47.
    Swan DA, et al: Analysis of symptomatic course and prognosis and treatment of hypertrophic obstructive cardiomyopathy. Br Heart J 33:671, 1971.PubMedCrossRefGoogle Scholar
  48. 48.
    Frank MJ, et al: Long term medical management of hypertrophic obstructive cardiomyopathy. Am J Cardiol 42:993, 1978.PubMedCrossRefGoogle Scholar
  49. 49.
    Vasquez M, et al: Clinical electrophysiological effects of propranolol on normal sinus node function. Br Heart J 41:709, 1979.PubMedCrossRefGoogle Scholar
  50. 50.
    Rosen KM, et al: Effects of lidocaine and propranolol on the normal and anomalous pathways in patients with pre-excitation. Am J Cardiol 30:801, 1972.PubMedCrossRefGoogle Scholar
  51. 51.
    Seides SF, et al: The electrophysiology of propranolol in man. Am Heart J 88:733, 1974.PubMedCrossRefGoogle Scholar
  52. 52.
    Strauss HC, et al: Electrophysiologic effects of propranolol on sinus node function inpatients with sinus node dysfunction. Circulation 54:452, 1976.PubMedGoogle Scholar
  53. 53.
    Winkle RA, et al: Antiarrhythmic effect assessed from ventricular arrhythmia reduction in the ambulatory electrocardiogram and treadmill test: a comparison of propranolol, procainamide and quinidine. Am J Cardiol 42:473, 1978.PubMedCrossRefGoogle Scholar
  54. 54.
    Koppes GM, et al: Propranolol therapy for ventricular arrhythmias 2 months after acute myocardial infarction. Am J Cardiol 46:322, 1980.PubMedCrossRefGoogle Scholar
  55. 55.
    Singh SN, et al: Comparison of acebutolol and propranolol for treatment of chronic ventricular arrhythmia: a placebo-controlled, double-blind, randomized crossover study. Circulation 65:1356, 1982.PubMedCrossRefGoogle Scholar
  56. 56.
    Woosley RL, et al: Suppression of chronic ventricular arrhythmias with propranolol. Circulation 60:819, 1979.PubMedGoogle Scholar
  57. 57.
    Mueller HS, et al: Propranolol during the evolution and subsequent ten days of myocardial infarction in man. Clin Cardiol 2:393, 1979.PubMedCrossRefGoogle Scholar
  58. 58.
    Morganroth J, et al: Effect of propranolol on ventricular arrhythmias in the ß-blocker heart attack trial (BHAT). Circulation [Suppl 2] 66:1313, 1982.Google Scholar
  59. 59.
    Chung EK: Wolff-Parkinson-White syndrome: current views. Am J Med 62:252, 1977.PubMedCrossRefGoogle Scholar
  60. 60.
    Callagher JJ, et al: The Wolff-Parkinson-White syndrome and the preexcitation dysrhythmias. Med Clin North Am 60:101, 1976.Google Scholar
  61. 61.
    Frishman WH, et al: Comparative effects of abrupt withdrawal of propranolol and verapamil in angina pectoris. Am J Cardiol 50:1191, 1982.PubMedCrossRefGoogle Scholar
  62. 62.
    Frishman WH, et al: Reversal of abnormal platelet aggregability and change in exercise tolerance in patients with angina pectoris following oral propranolol. Circulation 50:887, 1974.PubMedGoogle Scholar
  63. 63.
    Boudoulas H, et al: Hypertensitivity to adrenergic stimulation after propranolol withdrawal in normal subjects. Ann Intern Med 87:433, 1977.PubMedGoogle Scholar
  64. 64.
    Glaubiger G, Lefkowitz RJ: Elevated beta-adrenergic receptor number after chromic propranolol treatment. Biochem Biophys Res Commun 78:720, 1977.PubMedCrossRefGoogle Scholar
  65. 65.
    Alderman EL, et al: Coronary artery syndromes after sudden propranolol withdrawal. Ann Intern Med 81:625, 1974.PubMedGoogle Scholar
  66. 66.
    Nattel S, et al: Mechanism of propranolol withdrawal phenomena. Circulation 59:1158, 1979.PubMedGoogle Scholar
  67. 67.
    Thadani U, Parker JO: Propranolol in the treatment of angina pectoris: comparison of duraton of action in acute and sustained oral therapy. Circulation 59:571, 1979.PubMedGoogle Scholar
  68. 68.
    Dart AM, et al: The effect of chronic propranolol treatment on overnight plasma levels of anterior pituitary and related hormones. Br J Clin Pharmacol 12:849, 1981.PubMedGoogle Scholar
  69. 69.
    Kawashima K, et al: Stereospecific radioimmunoassay for propranolol isomers. J Pharmacol Exp Ther 196:517, 1976.PubMedGoogle Scholar
  70. 70.
    Levy A, et al: Disposition of propranolol isomers in mice. Eur J Pharmacol 40:93, 1976.PubMedCrossRefGoogle Scholar
  71. 71.
    Jackman GP, et al: No stereoselective first-pass hepatic extraction of propranolol. Clin Pharmacol Ther 30:291, 1981.PubMedCrossRefGoogle Scholar
  72. 72.
    Mizgala HG, et al: Propranolol in the prophylactic treatment of angina pectoris. Can Med Assoc J 100:756, 1969.PubMedGoogle Scholar
  73. 73.
    Zacest R, Koch-Weser J: Relation of propranolol plasma level to beta-blockade during oral therapy. Pharmacology 7:178, 1972.PubMedCrossRefGoogle Scholar
  74. 74.
    Evans GH, et al: The disposition of propranolol. III. Decreased half-life and volume of distribution as a result of plasma binding in man, monkey, dog and rat. J Pharmacol Exp Ther 186:114, 1973.PubMedGoogle Scholar
  75. 75.
    Wood AJJ, et al: Direct measurement of propranolol bioavailability during accumulation to steady state. Br J Clin Pharmacol 6:345, 1978.PubMedGoogle Scholar
  76. 76.
    Shand DG, et al: Plasma propranolol levels in adults. Clin Pharmacol Ther 11:112, 1970.PubMedGoogle Scholar
  77. 77.
    Castleden CM, George CF: The effect of ageing on the hepatic clearance of propranolol. Br J Clin Pharmacol 7:49, 1979.PubMedGoogle Scholar
  78. 78.
    Vestal RE, et al: Effects of age and cigarette smoking on propranolol disposition. Clin Pharmacol Ther 26:8, 1979.PubMedGoogle Scholar
  79. 79.
    Bendayan R, et al: Influence of age on serum protein binding of propranolol. Eur J Clin Pharmacol 26:251, 1984.PubMedCrossRefGoogle Scholar
  80. 80.
    Paxton JW, Briant RH: α-acid glycoprotein concentrations and propranolol binding in elderly patients with acute illness. Br J Clin Pharmacol 18:806, 1984.PubMedGoogle Scholar
  81. 81.
    Waller DG, et al: Intravenous propranolol in patients with inflammation [letter]. Br J Clin Pharmacol 13:577, 1982.PubMedGoogle Scholar
  82. 82.
    Greenblatt DJ, Koch-Weser J: Adverse reactions to propranolol in hospitalized medical patients: a report from the Boston Collaborative Drug Surveillance Program. Am Heart J 86:478, 1973.PubMedCrossRefGoogle Scholar
  83. 83.
    Solomon S, et al: Impairment of memory function by antihypertensive medication. Arch Gen Psychiatry 40:1109, 1983.PubMedGoogle Scholar

Copyright information

© Martinus Nijhoff Publishing, Boston 1988

Authors and Affiliations

  • Adam Schneeweiss
    • 1
  • Gotthard Schettler
    • 2
  1. 1.Geriatric Cardiology Research FoundationTel-AvivIsrael
  2. 2.Department of MedicineUniversity of HeidelbergGermany

Personalised recommendations