Beta-Blockers in the Management of Hypertension and/or Chronic Kidney Disease

Abstract

This minireview provides current summaries of beta-blocker use in the management of hypertension and/or chronic kidney disease. Accumulated evidence suggests that atenolol is not sufficiently effective as a primary tool to treat hypertension. The less-than-adequate effect of beta-blockers in lowering the blood pressure and on vascular protection, and the unfavorable effects of these drugs, as compared to other antihypertensive agents, on the metabolic profile have been pointed out. On the other hand, in patients with chronic kidney disease, renin-angiotensin system blockers are the drugs of first choice for achieving the goal of renal protection. Recent studies have reported that vasodilatory beta-blockers have adequate antihypertensive efficacy and less harmful effects on the metabolic profile, and also exert beneficial effects on endothelial function and renal protection. However, there is still not sufficient evidence on the beneficial effects of the new beta-blockers.

Blood pressure and antihypertensive medication profile in a multiethnic Asian population of stable chronic kidney disease patients

“…Even though medications in the same antihypertensive class have similar mechanisms of action, the medications may have demonstrable differences in their ability to reduce morbidity and mortality. (24)(25)(26) Large practice data analyses would be helpful in future to examine potential advantages of certain types of medications. (25) The present study had its limitations.…”

Allosteric “beta-blocker” isolated from a DNA-encoded small molecule library

“…So-called "β-blockers," which are orthosteric antagonists of the receptor, are mainstays of cardiovascular medicines used to treat a wide variety of illnesses (17)(18)(19). On the other hand, β-agonists have proven very effective against asthma (20).…”

Nebivolol Effects on Nitric Oxide Levels, Blood Pressure, and Renal Function in Kidney Transplant Patients

“…This is consistent with the relatively neutral physiologic effect of b-blockers on overall renal function. 46 Our analysis demonstrated that kidney allografts from older donors had achieved lower GFRs at the 12-month study visit and a decreased GFR relative to the baseline visit as compared with allografts from younger donors. These findings possibly reflect how aging affects the kidney by increasing glomerular, vascular, and tubular senescence resulting in decreased renal blood flow and GFR.…”

“…Our analysis did not show a difference in the effect of nebivolol and metoprolol on the renal function of kidney transplant recipients from baseline to the 12th month of the study. This is consistent with the relatively neutral physiologic effect of β‐blockers on overall renal function . Our analysis demonstrated that kidney allografts from older donors had achieved lower GFRs at the 12‐month study visit and a decreased GFR relative to the baseline visit as compared with allografts from younger donors.…”