[Endothelial dysfunction: role of vasodilating betablockers in hypertension and chronic heart failure].
The beneficial effects of beta blocking drugs in hypertension and heart failure are well known. However, this class of drugs is pharmacologically heterogeneous. In contrast to the non vasodilator betablockers like propranolol, atenolol or metoprolol which, in hypertension do not decrease intima media thinckness both in arterioles and large arteries, do not decrease arterial rigidity and can induce diabetes mellitus, the betablockers with vasodilating properties are beneficial on these parameters. Moreover, in heart failure, they more markedly decrease left ventricular workload than betablockers without any vascular relaxing effect and the results of SENIOR with nebivolol could suggest the beneficial role of NO on left ventricular dysfunction. Finally, the third generation betablockers, represented by celiprolol, carvedilol and nebivolol, have antioxidant properties which are probably implicated in their endothelial protective effects and in their absence of deleterious metabolic effects, effects which are probably of interest in term of protection of target organs during chronic treatment of hypertensive patients.
Thuillez
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Service de Pharmacologie, Institut de Biologie Clinique, INSERM U644, Université de Rouen CHU de Rouen, France. christian.thuillez@chu-rouen.fr <christian.thuillez@chu-rouen.fr>
D000319:Adrenergic beta-Antagonists / Q000145:classification / Q000627:therapeutic use*; D000975:Antioxidants / Q000627:therapeutic use; D004730:Endothelium, Vascular / Q000187:drug effects*; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D020011:Protective Agents / Q000627:therapeutic use; D017539:Tunica Intima / Q000187:drug effects; D017540:Tunica Media / Q000187:drug effects; D014665:Vasodilator Agents / Q000627:therapeutic use*; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy; D016277:Ventricular Function, Left / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D000975:Antioxidants; D020011:Protective Agents; D014665:Vasodilator Agents