DIFFERENT BETA-BLOCKERS USED IN THE TREATMENT OF CARDIOVASCULAR DISEASES AND ARTERIAL HYPERTENSION:

• DOI: https://doi.org/10.22533/at.ed.1595312530091

• Palavras-chave: Cardiovascular diseases, Hypertension, Metoprolol, Beta-blockers, Blood pressure

• Keywords: Cardiovascular diseases, Hypertension, Metoprolol, Beta-blockers, Blood pressure

• Abstract:

  This study reviews different literature addressing the topic of beta-blockers available for the treatment of cardiovascular diseases (CVDs) and hypertension (HTN). CVDs are the leading cause of global mortality, and HTN is one of the main risk factors. Blood pressure control is essential to prevent serious complications, such as myocardial infarction and stroke. Among the drugs used, beta-blockers play a crucial role. Beta-blockers are divided into selective and non-selective. Selective beta-blockers, such as metoprolol, primarily target beta-1 receptors, while non-selective beta-blockers, such as propranolol, bind to beta-1, beta-2, and, in some cases, alpha receptors. Metoprolol is available in two formulations: succinate (extended release) and tartrate (immediate release), with the choice depending on the patient's needs. In addition to metoprolol, other common beta-blockers include carvedilol, bisoprolol, atenolol, nebivolol, and propranolol. Each has specific characteristics that influence its clinical indication. For example, carvedilol is a non-selective beta-blocker that also blocks alpha-1 receptors, offering additional vasodilator effects. Beta-blockers have several physicochemical, pharmacokinetic, and pharmacodynamic characteristics that influence their efficacy and safety profile. Physicochemical characteristics include water and lipid solubility, which affect drug absorption and distribution. Pharmacokinetic properties involve the absorption, distribution, metabolism, and excretion of beta-blockers. Pharmacodynamic characteristics refer to the mechanism of action of beta-blockers, which block β-adrenergic receptors, reducing heart rate and myocardial contraction force. Chemically, beta-blockers have structures that allow them to interact with β-adrenergic receptors. The technical data sheet for each beta-blocker provides detailed information on its composition, pharmaceutical form, therapeutic indications, dosage, and administration. The proper use of these drugs, combined with lifestyle changes, contributes to reducing cardiovascular mortality and improving the quality of life of hypertensive patients. Beta-blockers exert their pharmacological action through antagonism of β-adrenergic receptors in the myocardium, resulting in a cascade of physiological effects that modulate cardiovascular function. The binding of beta-blockers to β1 receptors attenuates the heart's response to adrenergic stimuli, reducing heart rate and myocardial contraction force. This decrease in cardiac output, together with the possible reduction in renin release by the kidneys, contributes to the effectiveness of beta-blockers in controlling blood pressure. In addition, the reduction in myocardial oxygen demand makes these drugs useful in the treatment of angina pectoris. The modulation of heart rate justifies their use in various arrhythmias. In summary, the literature review on the different beta-blockers available highlights the importance of these drugs in the treatment of CVD and AH. The choice of the appropriate beta-blocker depends on the individual needs of patients and adherence to treatment. The combined use of these drugs with lifestyle changes is essential for effective blood pressure control and prevention of serious complications.