Beta‐blockers reduce the release and synthesis of endothelin‐1 in human endothelial cells

Abstract

The effect of beta-adrenergic antagonists on ET-1 production of the endothelium may at least partially explain the efficacy of beta-blockers in the treatment of diseases such as advanced heart failure, essential hypertension as well as acute coronary syndromes.

Bisoprolol in COPD study

“…Sub-group analysis of participants with clinically diagnosed heart disease to determine whether any beneficial effects of bisoprolol are limited to those with clinically diagnosed heart disease. Version 4,30 …”

“…Bisoprolol is cheap (4p/day) and if it works it will improve the lives people with COPD and reduce the costs of COPD to the NHS. Version 4,30 Beta-blockers are a well-established therapy in cardiovascular medicine because of beneficial effects on morbidity and mortality in people with ischaemic heart disease. There is now a substantial body of evidence from observational studies demonstrating that beta-blocker use in people with COPD is associated with a reduced risk of COPD exacerbations, moreover the beneficial association with exacerbations extends to people with COPD without cardiovascular disease and appears to be restricted to beta-blockers and not evident with other cardioactive drugs e.g.…”

“…calcium channel blockers, ACE inhibitors, AR blockers) having no demonstrable effect on the risk of COPD exacerbation. Version 4,30 Possible mechanisms by which beta-blockers could reduce COPD exacerbations The mechanisms by which beta-blockers may reduce exacerbations remain uncertain though several explanations are biologically plausible. 1.…”

“…2. Beta-blockers have some direct anti-inflammatory properties potentially relevant to COPD exacerbations [30,31]. 3.…”

“…In the letter we will indicate to the GP that this would be outwith the licence for bisoprolol, that the patient may have been on placebo or bisoprolol and that dose-titration would be required. Version 4,30 Bisoprolol is licensed for the treatment of angina, hypertension and heart failure. In BICS bisoprolol will be used 'off label' to people with COPD.…”