Dotzer F, Gromer H
Krankenhaus München-Perlach.
Fortschr Med. 1993 Aug 30;111(24):382-4.
The major indications for beta receptor blockers include, in addition to arterial hypertension, various clinical manifestations of coronary heart disease. Used as antihypertensive agents, beta receptor blockers bring about regression of myocardial hypertrophy and an improvement in diastolic ventricular function. Anti-anginal effects are utilized in the treatment of symptomatic and asymptomatic myocardial ischemia, as well as for secondary prophylaxis after acute myocardial infarction. A detailed knowledge of the subtypes of adrenoceptors--in particular beta-1 receptors in the case of the heart--led to the development of largely organ-specific antagonists. In contrast to nonspecific beta blockers, beta-1 selective substances, for example, atenolol, have only a mild, clinically non-relevant, effect on glucose and lipid metabolism.
β受体阻滞剂的主要适应证除了动脉高血压外,还包括冠心病的各种临床表现。作为抗高血压药物,β受体阻滞剂可使心肌肥厚消退,并改善心室舒张功能。其抗心绞痛作用可用于治疗有症状和无症状的心肌缺血,以及急性心肌梗死后的二级预防。对肾上腺素能受体亚型,特别是心脏中的β-1受体的详细了解,促使了大部分具有器官特异性的拮抗剂的研发。与非特异性β受体阻滞剂相比,β-1选择性药物,如阿替洛尔,对葡萄糖和脂质代谢仅有轻微的、临床上无关紧要的影响。