Pharmacology of Propranolol as an Antihypertensive Drug
DOI:
https://doi.org/10.55544/jrasb.4.3.3Keywords:
Propranolol, Beta-blockers, Hypertension, Pharmacology, Renin-angiotensin systemAbstract
Propranolol, a non-selective beta-adrenergic receptor antagonist, has long been used in the treatment of hypertension. It lowers blood pressure through several mechanisms, including reducing heart rate, myocardial contractility, and inhibiting renin release. Despite newer antihypertensive agents, propranolol continues to play a role, particularly in patients with concomitant cardiovascular conditions. This review examines its pharmacological mechanisms, clinical effectiveness, side effects, and its ongoing relevance in hypertension management.
Downloads
References
Mancia G. Introduction to a compendium on hypertension. Circ Res. 2015 Mar 13;116(6):923-4. doi: 10.1161/CIRCRESAHA.115.305755. PMID: 25767280.
Mancia G, Hall JE. Introduction to a Compendium on the Pathophysiology and Treatment of Hypertension. Circ Res. 2019 Mar 29;124(7):967-968. doi: 10.1161/CIRCRESAHA.119.314953. PMID: 30920925.
Ogden LG, He J, Lydick E, et al. Long-term absolute benefit of lowering blood pressure in hypertensive patients according to the JNC VI Risk Stratification. Hypertension 2000; 34:539 43.
Xiao L, Harrison DG. Inflammation in Hypertension. Can J Cardiol. 2020 May;36(5):635-647. doi: 10.1016/j.cjca.2020.01.013. Epub 2020 Jan 24. PMID: 32389337; PMCID: PMC7733126
Carretero OA, Oparil S.Essential hypertension. Part I: definition and etiology. Circulation. 2000 Jan 25;101(3):329-35. PMID: 10645931.
Rossi, B., Angiari, S., Zenaro, E., Budui, S.L., Constantin, G., 2011. Vascular inflammation in central nervous system diseases: adhesion receptors controlling leukocyteendothelial interactions. J Leukoc Biol 89,539-556.
Piecha G, Wiecek A, Januszewicz A.Epidemiology and optimal management in patients with renal artery stenosis. J Nephrol. 2012 Nov-Dec;25(6):872-8.
Rossi, B., Angiari, S., Zenaro, E., Budui, S.L., Constantin, G., 2011. Vascular inflammation in central nervous system diseases: adhesion receptors controlling leukocyteendothelial interactions. J Leukoc Biol 89,539-556.
Rehsia NS, Dhalla NS. Mechanisms of the beneficial effects of beta-adrenoceptor antagonists in congestive heart failure. Exp Clin Cardiol. 2010 Winter;15(4):e86-95. [PMC free article] [PubMed]
Wang DW, Mistry AM, Kahlig KM, Kearney JA, Xiang J, George AL. Propranolol blocks cardiac and neuronal voltage-gated sodium channels. Front Pharmacol. 2010;1:144. [PMC free article] [PubMed]
Metra M, Nodari S, Dei Cas L. Beta-blockade in heart failure: selective versus nonselective agents. Am J Cardiovasc Drugs. 2001;1(1):3-14. [PubMed]
Frishman WH. β-Adrenergic blockers: A 50-year historical perspective. Am J Cardiol. 2015;116(8 Suppl):1-8.
Katulanda P, et al. Addition of Propranolol in Resistant Arterial Hypertension Treatment: A Randomized Controlled Trial. Trials. 2017;18:124.
Beevers G, Lip GY, O'Brien E. ABC of hypertension: The pathophysiology of hypertension. BMJ. 2001 Apr 14;322(7291):912-6. doi: 10.1136/bmj.322.7291.912. PMID: 11302910; PMCID: PMC1120075.
McInnes G, et al. Propranolol for the management of pheochromocytoma. Endocrine Reviews. 2016;37(3):248-267.
Turnbull F, et al. Propranolol in the prevention of migraine. Lancet. 2005;365(9463):935-944.
Frishman WH, et al. Propranolol in the treatment of hypertension with co-existing coronary artery disease. Am J Hypertens. 2001;14(12):1224-1229.
Naylor R, et al. Propranolol in the management of hyperthyroidism. Endocrine Practice. 2016;22(7):815-821.
Zanchetti A, et al. The role of beta-blockers in hypertension. J Hypertens. 2017;35(6):1215 1224.
Ji Y, Chen S, Wang Q, Xiang B, Xu Z, Zhong L, Yang K, Lu G, Qiu L. Intolerable side effects during propranolol therapy for infantile hemangioma: frequency, risk factors and management. Sci Rep. 2018 Mar 09;8(1):4264.
Bhatia M, et al. Cardiovascular adverse effects of beta-blockers. Cardiology Reviews. 2015;23(4):247-251.
Nissen SE, et al. Respiratory effects of propranolol: Contraindications in asthma. JAMA. 1995;273(7):473-478.
Dubé MP, et al. CNS side effects of propranolol: Depression and fatigue. J Clin Psychopharmacol. 1997;17(2):124-130.
Arnett D, et al. Propranolol and the risk of hypoglycemia in diabetic patients. Diabetes Care. 2014;37(6):1437-1442.
Peterson CD, Leeder JS, Sterner S. Glucagon therapy for beta-blocker overdose. Drug Intell Clin Pharm. 1984 May;18(5):394-8
Martin K, Blei F, Chamlin SL, Chiu YE, Frieden IJ, Frommelt PC, Garzon MC, Kwon EK, MacLellan-Tobert S, Mancini AJ, Seefeldt M, Sidbury R, Siegel DH, Drolet BA, Boucek RJ. Propranolol treatment of infantile hemangiomas: anticipatory guidance for parents and caretakers. Pediatr Dermatol. 2013 Jan-Feb;30(1):155-9.
Farzam K, Jan A. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 22, 2023. Beta Blockers.
Ji Y, Chen S, Wang Q, Xiang B, Xu Z, Zhong L, Yang K, Lu G, Qiu L. Intolerable side effects during propranolol therapy for infantile hemangioma: frequency, risk factors and management. Sci Rep. 2018 Mar 09;8(1):4264.
Cohn JN, et al. Beta-blockers: A comprehensive review. JAMA. 2006;295(3):291-301.
Tfelt-Hansen P. Propranolol in migraine prophylaxis: A review of clinical studies. Acta Neurologica Scandinavica. 2008;118(3):161-167.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Vineet Sen, Nisha Bano, Nikhil Trivedi

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.








