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DiNicolantonio JJ, Fares H, Niazi AK, et al. β-Blockers in hypertension, diabetes, heart failure and acute myocardial infarction: a review of the literature. Open Heart. 2015;2(1):e000230doi: 10.1136/openhrt-2014-000230.
DiNicolantonio, J. J., Fares, H., Niazi, A. K., Chatterjee, S., D'Ascenzo, F., Cerrato, E., Biondi-Zoccai, G., Lavie, C. J., Bell, D. S., & O'Keefe, J. H. (2015). β-Blockers in hypertension, diabetes, heart failure and acute myocardial infarction: a review of the literature. Open heart, 2(1), e000230. https://doi.org/10.1136/openhrt-2014-000230
DiNicolantonio, James J, et al. "β-Blockers in hypertension, diabetes, heart failure and acute myocardial infarction: a review of the literature." Open heart vol. 2,1 (2015): e000230. doi: https://doi.org/10.1136/openhrt-2014-000230
DiNicolantonio JJ, Fares H, Niazi AK, Chatterjee S, D'Ascenzo F, Cerrato E, Biondi-Zoccai G, Lavie CJ, Bell DS, O'Keefe JH. β-Blockers in hypertension, diabetes, heart failure and acute myocardial infarction: a review of the literature. Open Heart. 2015 Mar 21;2(1):e000230. doi: 10.1136/openhrt-2014-000230. eCollection 2015. PMID: 25821584; PMCID: PMC4371808.
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Open Heart. 2015 Mar 21;2(1):e000230. doi: 10.1136/openhrt-2014-000230. eCollection 2015.

β-Blockers in hypertension, diabetes, heart failure and acute myocardial infarction: a review of the literature.

Open heart

James J DiNicolantonio, Hassan Fares, Asfandyar K Niazi, Saurav Chatterjee, Fabrizio D'Ascenzo, Enrico Cerrato, Giuseppe Biondi-Zoccai, Carl J Lavie, David S Bell, James H O'Keefe

Affiliations

  1. Mid America Heart Institute at Saint Luke's Hospital , Kansas City, Missouri , USA.
  2. John Ochsner Heart and Vascular Institute, Ochsner Clinical School- The University of Queensland School of Medicine , New Orleans, Louisiana , USA.
  3. Shifa College of Medicine , Islamabad , Pakistan.
  4. St Luke's Roosevelt Hospital Center , New York, New York , USA.
  5. University of Turin, Citta Della Salute e Della Scienza , Torino , Italy.
  6. Sapienza University of Rome , Latina , Italy.
  7. John Ochsner Heart and Vascular Institute, Ochsner Clinical School- The University of Queensland School of Medicine , New Orleans, Louisiana , USA ; Department of Preventive Medicine , Pennington Biomedical Research Center , Baton Rouge, Louisiana , USA.
  8. Southside Endocrinology, University of Alabama at Birmingham.
  9. Mid America Heart Institute at Saint Luke's Hospital, University of Missouri-Kansas City , Kansas City, Missouri , USA.

PMID: 25821584 PMCID: PMC4371808 DOI: 10.1136/openhrt-2014-000230

Abstract

β-Blockers (BBs) are an essential class of cardiovascular medications for reducing morbidity and mortality in patients with heart failure (HF). However, a large body of data indicates that BBs should not be used as first-line therapy for hypertension (HTN). Additionally, new data have questioned the role of BBs in the treatment of stable coronary heart disease (CHD). However, these trials mainly tested the non-vasodilating β1 selective BBs (atenolol and metoprolol) which are still the most commonly prescribed BBs in the USA. Newer generation BBs, such as the vasodilating BBs carvedilol and nebivolol, have been shown not only to be better tolerated than non-vasodilating BBs, but also these agents do not increase the risk of diabetes mellitus (DM), atherogenic dyslipidaemia or weight gain. Moreover, carvedilol has the most evidence for reducing morbidity and mortality in patients with HF and those who have experienced an acute myocardial infarction (AMI). This review discusses the cornerstone clinical trials that have tested BBs in the settings of HTN, HF and AMI. Large randomised trials in the settings of HTN, DM and stable CHD are still needed to establish the role of BBs in these diseases, as well as to determine whether vasodilating BBs are exempt from the disadvantages of non-vasodilating BBs.

Keywords: HEART FAILURE; beta-blockers; carvedilol; myocardial infarction

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