They who are afflicted with it are seized …with a painful and most disagreeable sensation in the breast, which seems as if it would extinguish life … William Heberden, British physician, 1768. A classic description of an impending heart attack.
Cardiovascular disease is the number one killer in the world. And as late as the 1950’s, doctors couldn’t do much about it.
Sir James Black at Imperial Chemical Industries, UK tried to tackle the issue by developing drugs that could decrease the heart’s demand for oxygen, thereby reducing the strain on it. Along with chemist John Stephenson, he developed a series of compounds, one of which was code-named ICI 45,520.
ICI 45,520 did decrease oxygen demand and slowed down racing hearts. Patients treated with the drug had a death rate four times less than those who had not received the drug.
ICI 45,520 was officially launched by ICI in 1964 as Propranolol under the brand Inderal.
Sir James Black flagged off the age of the beta-blockers.
Propranolol is a remarkably versatile drug. It has proved useful in managing many heart ailments like essential hypertension, arrhythmias and cardiomyopathy (weakening of the heart muscle).
Propanolol is prescribed for migraines and cluster headaches. It is also used in the management of anxiety and post-traumatic stress. Propranolol, in fact, prominently featured in Selling Sickness, a famous episode of Boston Legal, in which a vehement argument is made for the use of propranolol in treating a teenage rape victim.
Stage performers use propranolol for stage-fright and even surgeons are known to use it to control hand tremors during surgery.
Black’s beta-blocker is currently being tested as a potential anti-cancer drug and for the management of malaria. Clearly, propranolol is a multi-faceted drug that will be with us for a long time to come.
No wonder James Black picked up a Knighthood and a Nobel, among several other honors and awards.
Cardiologists today have several beta-blockers at their disposal, but their first choice would still be Black’s Boon – propranolol.
To be continued …