CC BY-NC-ND 4.0 · Journal of Cardiac Critical Care TSS 2022; 06(03): 206-209
DOI: 10.1055/s-0042-1759804
Review Article

Beta-Adrenergic Blockade: Is It the Prudent Choice against Sympathetic Overdrive in Patients with Hypertension or Heart Failure?

H.K Chopra
1   Department of Cardiology, Medanta Moolchand Heart Institute - Moolchand Medcity, New Delhi, India
A.K Pancholia
2   Department of Medicine and Preventive Cardiology, Arihant Hospital and Research Center, Indore, Madhya Pradesh, India
Bhupen N. Desai
3   Department of Cardiology, Desai Heart Care Clinic, Mumbai, Maharashtra, India
Ajay K. Sinha
4   Department of Clinical Cardiology and Research, Jaiprabha Medanta Super Speciality Hospital, Patna, Bihar, India
Dhammdeep Dabhade
5   Department of Medical Services, Emcure Pharmaceuticals Ltd., Pune, Maharashtra, India
Sanket Newale
5   Department of Medical Services, Emcure Pharmaceuticals Ltd., Pune, Maharashtra, India
› Author Affiliations


The development of hypertension and heart failure is correlated with the hyperactivation of the sympathetic nervous system. Beta-blockers are often considered a good therapeutic option in such clinical scenarios. However, the choice of β-blocker is a concern because of certain aspects like associated metabolic disturbances with their usage. Metoprolol has been reported to have the potential to alleviate sympathetic overdrive in patients with hypertension and heart failure. S-Metoprolol is the chirally pure β-blocker with favorable pharmacological features, improved safety profile, and allied clinical advantages versus racemic metoprolol; given this, can it be an effective therapeutic option against sympathetic overdrive in patients with hypertension and/or heart failure is not fully recognized yet. In this review, we attempted to discuss the current facts around sympathetic overdrive linked with hypertension as well as heart failure and pertaining pharmacological intervention with a focus on β-blockers in these clinical situations with an emphasis on the likely beneficial role of S-metoprolol.


The views expressed in this publication represent those of the author(s).

Publication History

Article published online:
03 December 2022

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