The effect of beta-blockers on bone metabolism as potential drugs under investigation for osteoporosis and fracture healing.
BACKGROUND
beta-Adrenergic receptor antagonists (beta-blockers) have a well-recognised antihypertensive action that is mediated through a reduction in cardiac output and in the release of renin from the kidneys and inhibition of the action of endogenous catecholamines on beta-adrenergic receptors. This class of drugs has been shown to reduce the incidence of cardiovascular disease. Recent evidence suggests that beta-blockers may also have an effect on bone structure, metabolism and fracture healing.


OBJECTIVE
This paper reviews in vitro and in vivo data that suggest beta-blockers have primarily an anabolic effect on bone metabolism.


RESULTS
The sympathetic nervous system has a catabolic effect on bone, and in vitro studies have shown that adrenergic agonists stimulate bone resorption. The beta-blocker propranolol has been shown to increase bone formation in ovariectomised female rats. Also, recent observational clinical studies provide evidence to show that beta-blockers are associated with reduction in fracture risk in both men and women.


CONCLUSIONS
Although there are some controversial studies, most research concludes that beta-blockers show promise in the treatment of osteoporosis and fracture healing.
Graham
Simon
S
University of Leeds, Academic Department of Trauma and Orthopaedics, School of Medicine, Clarendon Wing A, Leeds Teaching Hospitals, Leeds General Infirmary NHS Trust, Great George Street, Leeds, LS1 3EX, UK.
Hammond-Jones
Dafydd
D
Gamie
Zakareya
Z
Polyzois
Ioannis
I
Tsiridis
Evgenios
E
Tsiridis
Eleftherios
E
D000319:Adrenergic beta-Antagonists / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000818:Animals; D004353:Drug Evaluation, Preclinical; D017102:Fracture Healing / Q000187:drug effects*; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy* / Q000378:metabolism*; D013564:Sympathetic Nervous System / Q000187:drug effects / Q000378:metabolism
D000319:Adrenergic beta-Antagonists