Beta-Blockers For Hypertension Treatment: Mechanism and Types- Pharmocology Notes

Beta-blockers are a class of medications commonly prescribed to reduce hypertension (high blood pressure). They work by affecting the sympathetic nervous system and specific receptors in the body, primarily beta-adrenergic receptors. Here's how beta-blockers reduce hypertension:

Decreasing Heart Rate: Beta-blockers block the action of adrenaline (epinephrine) and other similar hormones on beta-adrenergic receptors in the heart. By doing so, they reduce the heart rate. A slower heart rate means that the heart pumps blood with less force and less frequently, resulting in decreased cardiac output. This reduction in cardiac output leads to a decrease in blood pressure.

Reducing Contractility: Beta-blockers also reduce the force of contraction of the heart muscle. This effect, known as negative inotropy, means that the heart muscle contracts less forcefully with each beat. As a result, the heart pumps out less blood with each beat, leading to a decrease in stroke volume (the amount of blood ejected from the heart with each beat). This, in turn, contributes to a decrease in blood pressure.

Blocking Beta-Adrenergic Receptors in Blood Vessels: Beta-blockers can block beta-adrenergic receptors in the smooth muscle cells of blood vessels. By doing so, they reduce the vasoconstrictive effects of adrenaline and similar hormones. This leads to vasodilation, or the widening of blood vessels, which lowers peripheral vascular resistance. When blood vessels are more relaxed and dilated, there is less resistance to blood flow, resulting in lower blood pressure.

Reducing Renin Release: Beta-blockers can inhibit the release of renin, an enzyme involved in regulating blood pressure. Lower renin levels lead to decreased production of angiotensin II, a potent vasoconstrictor, and aldosterone, a hormone that promotes sodium and water retention. These effects contribute to lower blood pressure.

Beta-blockers used for treating hypertension

Propranolol (Inderal): Propranolol is a non-selective beta-blocker that blocks both beta-1 and beta-2 adrenergic receptors. It is used to treat high blood pressure, as well as various heart conditions like angina, arrhythmias, and migraines.

Atenolol (Tenormin): Atenolol is a cardioselective beta-blocker, primarily affecting beta-1 adrenergic receptors in the heart. It is commonly used to manage hypertension and prevent heart attacks.

Metoprolol (Lopressor, Toprol-XL): Metoprolol is another cardioselective beta-blocker primarily affecting beta-1 receptors. It is often prescribed to control blood pressure and manage heart conditions, such as angina and heart failure.

Bisoprolol (Zebeta): Bisoprolol is a cardioselective beta-blocker used to treat hypertension and improve heart function in patients with heart failure.

Carvedilol (Coreg): Carvedilol is a non-selective beta-blocker with alpha-blocking properties. It is prescribed for hypertension and congestive heart failure.

Nebivolol (Bystolic): Nebivolol is a cardioselective beta-blocker with additional vasodilatory properties. It is used to treat high blood pressure.

Labetalol (Normodyne, Trandate): Labetalol is a non-selective beta-blocker with alpha-blocking properties. It is used to manage hypertension, particularly in emergencies like hypertensive crises during pregnancy.

Acebutolol (Sectral): Acebutolol is a cardioselective beta-blocker used for hypertension management.

Pindolol (Visken): Pindolol is a non-selective beta-blocker with intrinsic sympathomimetic activity. It is used to treat high blood pressure.

Esmolol (Brevibloc): Esmolol is a short-acting beta-blocker often administered intravenously to rapidly lower blood pressure in emergency situations.

Timolol (Blocadren): Timolol is a non-selective beta-blocker used for hypertension and to prevent migraines.

Oxprenolol (Trasicor): Oxprenolol is a non-selective beta-blocker used for hypertension management.


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