Potential mechanisms of the cardioprotective effects of beta blockade

The many steps from the onset of coronary artery disease to death from myocardial infarction or ventricular fibrillation are complex and not fully understood. However, the major disease processes include endothelial damage, lipid deposition, clot formation, and increased myocardial excitability. Evidence is accumulating that certain beta blockers may moderate each of these and might therefore delay the progression of ischemic heart disease. Studies have shown that beta blockers reduce vascular damage, lipid binding to subendothelial tissues, and atheromatous plaque formation in animals fed an atherogenic diet. Data also demonstrate the ability of beta blockers to counteract clot formation and to reduce the incidence of ventricular fibrillation in the infarcted hearts of animals and humans.