Beta-Adrenergic Blockade: Is It the Prudent Choice against Sympathetic Overdrive in Patients with Hypertension or Heart Failure?

Journal of Cardiac Critical Care TSS Pub Date : 2022-07-01 DOI:10.1055/s-0042-1759804

H. Chopra, A. Pancholia, Bhupen N. Desai, A. Sinha, Dhammdeep C. Dabhade, S. Newale

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Abstract

Abstract The development of hypertension and heart failure is correlated with the hyperactivation of the sympathetic nervous system. Beta-blockers are often considered a good therapeutic option in such clinical scenarios. However, the choice of β-blocker is a concern because of certain aspects like associated metabolic disturbances with their usage. Metoprolol has been reported to have the potential to alleviate sympathetic overdrive in patients with hypertension and heart failure. S-Metoprolol is the chirally pure β-blocker with favorable pharmacological features, improved safety profile, and allied clinical advantages versus racemic metoprolol; given this, can it be an effective therapeutic option against sympathetic overdrive in patients with hypertension and/or heart failure is not fully recognized yet. In this review, we attempted to discuss the current facts around sympathetic overdrive linked with hypertension as well as heart failure and pertaining pharmacological intervention with a focus on β-blockers in these clinical situations with an emphasis on the likely beneficial role of S-metoprolol.

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肾上腺素能阻滞剂:是高血压或心力衰竭患者对抗交感神经过度亢进的审慎选择吗?

高血压和心力衰竭的发生与交感神经系统的过度激活有关。在这种临床情况下，β受体阻滞剂通常被认为是一种很好的治疗选择。然而，β受体阻滞剂的选择是一个问题，因为某些方面，如相关的代谢紊乱与他们的使用。据报道，美托洛尔有可能缓解高血压和心力衰竭患者的交感神经过度亢进。s -美托洛尔是手性纯β受体阻滞剂，与外消旋美托洛尔相比，具有良好的药理特性、更高的安全性和相关的临床优势;鉴于此，它能否成为高血压和/或心力衰竭患者交感神经过度亢进的有效治疗选择尚不完全清楚。在这篇综述中，我们试图讨论当前与高血压和心力衰竭相关的交感神经过度亢进和相关的药物干预，重点是β受体阻滞剂在这些临床情况下的作用，并强调s -美托洛尔可能的有益作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Journal of Cardiac Critical Care TSS

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21 weeks