Features of pharmacotherapy β1- adrenoblocker with activation of endothelial nitric oxide nebivolol in patients with coronary heart disease on the background of chronic heart failure (review of literature)

Abstract

The use of P-adrenergic blockers (P-blockers) in heart failure has been considered controversial for many years. However, they are recommended as a first-line treatment for chronic heart failure, coronary heart disease, atrial fibrillation, and in patients with recent acute myocardial infarction. Randomized clinical trials and meta-analyses have shown that long-term use of P-blockers improves the outcome of patients with coronary heart failure, leading to a significant reduction in the risk of cardiovascular events, mortality and sudden death. The choice of therapy in patients with cardiovascular disease must consider the presence of risk factors and concomitant conditions, as well as the individual characteristics of the drugs in question. Nebivolol induces mediated vasodilation by stimulating endothelial nitric oxide synthase through P3-agonism. This mechanism of action accentuate several hemodynamic qualities of nebivolol, which include reduced heart rate, blood pressure, improved systolic and diastolic heart function. The literature review presents data on the use of P-blockers in relation to cardiovascular diseases, the pharmacological profile of nebivolol, as well as clinical data confirming its positive effect on the course of chronic heart failure. Ключевые слова: бета-адреноблокаторы (Р-блокаторы), хроническая небиволол, оксид азота (NO). approaches to the interpretation of the results of clinical studies of beta-blockers in the treatment of patients with chronic heart failure] Ratsional'naya