Beta-blockers have become a top-tier medical therapy for chronic heart failure, with future improvements possible through novel receptor biology approaches and pharmacogenetic targeting.
This review highlights the historical development of beta-blockers into a foundational therapy for chronic heart failure and suggests future directions for antiadrenergic therapies.
Despite the absence of a systematic development plan, β-blockers have reached the top tier of medical therapies for chronic heart failure. The successful outcome was due to the many dedicated investigators who produced, over a 30-year period, increasing evidence that β-blocking agents should or actually did improve the natural history of dilated cardiomyopathies and heart failure. It took 20 years for supportive evidence to become undeniable, at which time in 1993 the formidable drug development resources of large pharmaceutical companies were deployed into Phase 3 trials. Success then came relatively quickly, and within 8 years multiple agents were on the market in the United States and Europe. Importantly, there is ample room to improve antiadrenergic therapy, through novel approaches exploiting the nuances of receptor biology and/or intracellular signaling, as well as through pharmacogenetic targeting.
Michael R. Bristow (Thu,) conducted a review in Chronic Heart Failure. β-Adrenergic Receptor Antagonists was evaluated. Beta-blockers have become a top-tier medical therapy for chronic heart failure, with future improvements possible through novel receptor biology approaches and pharmacogenetic targeting.