Beta Blockers – A Revolution in Drug Design

The Scottish physician James Black revolutionized the pharmaceutical industry through rational, targeted drug design. With this approach, Dr. Black created the world's first drugs to generate billions of dollars while saving millions of lives.

Black noted that, during stress, the body secretes more of a hormone that raises heart rate and requires a greater oxygen supply to the heart muscle: adrenaline —also known as epinephrine. He thought that reducing this stress might benefit people with weakened hearts.

He turned his attention to beta receptors—sites in the heart muscle where adrenaline binds to make the heart work harder. Black believed that if he could design a drug structurally similar to the adrenaline molecule, it could bind to the receptor and block adrenaline's effect. This was like putting chewing gum in a lock to prevent a key from opening it. Rather than starting with a naturally occurring chemical, Black and his colleagues pursued a rational, deliberate drug-design process based on their in-depth understanding of molecular and physiological processes and biological targets. 

In the early 1960s, Black discovered the first clinically important beta-blocker drug, propranolol. Since then, beta blockers have played important roles in protecting the heart after a heart attack and in treating the following conditions:

• Angina pectoris (pain caused by a lack of blood and oxygen to the heart)
• High blood pressure
• Heart rhythm disorders
• Migraine
• Performance anxiety (for example, in musicians and public speakers)
• Glaucoma (a condition often associated with increased pressure in the eye) 

Beta blockers have also been used by surgeons, marksmen and archers to reduce tremors and improve performance. However, such drugs have been banned by the International Olympic Committee.

For his work in drug design, including cimetidine (brand name Tagamet), used to treat stomach ulcers, Black was awarded the 1988 Nobel Prize. When told that he had won, Black joked: “I wish I had my beta blockers with me”.

About the Article Image: James Whyte Black

Historical Figures Mentioned in the Article: James Whyte Black (1924–2010)

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