BACKGROUND: beta-Adrenergic receptor antagonists (beta-blockers) have a well-recognised antihypertensive action that is mediated through a reduction in cardiac output and in the release of renin from the kidneys and inhibition of the action of endogenous catecholamines on beta-adrenergic receptors. This class of drugs has been shown to reduce the incidence of cardiovascular disease. Recent evidence suggests that beta-blockers may also have an effect on bone structure, metabolism and fracture healing. OBJECTIVE: This paper reviews in vitro and in vivo data that suggest beta-blockers have primarily an anabolic effect on bone metabolism. RESULTS: The sympathetic nervous system has a catabolic effect on bone, and in vitro studies have shown that adrenergic agonists stimulate bone resorption. The beta-blocker propranolol has been shown to increase bone formation in ovariectomised female rats. Also, recent observational clinical studies provide evidence to show that beta-blockers are associated with reduction in fracture risk in both men and women. CONCLUSION: Although there are some controversial studies, most research concludes that beta-blockers show promise in the treatment of osteoporosis and fracture healing.
BACKGROUND: beta-Adrenergic receptor antagonists (beta-blockers) have a well-recognised antihypertensive action that is mediated through a reduction in cardiac output and in the release of renin from the kidneys and inhibition of the action of endogenous catecholamines on beta-adrenergic receptors. This class of drugs has been shown to reduce the incidence of cardiovascular disease. Recent evidence suggests that beta-blockers may also have an effect on bone structure, metabolism and fracture healing. OBJECTIVE: This paper reviews in vitro and in vivo data that suggest beta-blockers have primarily an anabolic effect on bone metabolism. RESULTS: The sympathetic nervous system has a catabolic effect on bone, and in vitro studies have shown that adrenergic agonists stimulate bone resorption. The beta-blocker propranolol has been shown to increase bone formation in ovariectomised female rats. Also, recent observational clinical studies provide evidence to show that beta-blockers are associated with reduction in fracture risk in both men and women. CONCLUSION: Although there are some controversial studies, most research concludes that beta-blockers show promise in the treatment of osteoporosis and fracture healing.
Authors: W F Rodrigues; M F M Madeira; T A da Silva; J T Clemente-Napimoga; C B Miguel; V J Dias-da-Silva; O Barbosa-Neto; A H Lopes; M H Napimoga Journal: Br J Pharmacol Date: 2012-04 Impact factor: 8.739
Authors: Melanie Haffner-Luntzer; Sandra Foertsch; Verena Fischer; Katja Prystaz; Miriam Tschaffon; Yvonne Mödinger; Chelsea S Bahney; Ralph S Marcucio; Theodore Miclau; Anita Ignatius; Stefan O Reber Journal: Proc Natl Acad Sci U S A Date: 2019-04-04 Impact factor: 11.205
Authors: Joshua I Barzilay; Barry R Davis; Sara L Pressel; Alokananda Ghosh; Rachel Puttnam; Karen L Margolis; Paul K Whelton Journal: Curr Cardiol Rep Date: 2017-09 Impact factor: 2.931
Authors: T Sato; K Miyazawa; Y Suzuki; Y Mizutani; S Uchibori; R Asaoka; M Arai; A Togari; S Goto Journal: J Dent Res Date: 2014-05-27 Impact factor: 6.116
Authors: Russell T Turner; Satya P Kalra; Carmen P Wong; Kenneth A Philbrick; Laurence B Lindenmaier; Stephane Boghossian; Urszula T Iwaniec Journal: J Bone Miner Res Date: 2013-01 Impact factor: 6.741