Do partial agonist beta-blockers have improved clinical utility?

Although beta-blockers were introduced into clinical medicine 30 thirty years ago, controversy continues as to the optimal pharmacodynamic profile of such agents. This commentary reviews the development of beta-blockers with partial agonist properties in the context of a recent study on epanolol. The influence of partial agonism on the efficacy and tolerability of beta-blockers is summarized, and it is concluded that, in general, there is little convincing evidence from controlled clinical studies that partial agonism confers significant clinical benefit over full antagonists.