Sir James Black and propranolol. The role of the basic sciences in the history of cardiovascular pharmacology

Abstract

The history of cardiology encompasses some of the most revered names in medical history, many belonging to physicians who have advanced knowledge beyond their time. However, there have been countless others whose work in the basic sciences has paid large dividends to clinical cardiology. The original example of such an individual is William Harvey, whose reasoned experimentation led to the understanding of the circulation of blood. Another such man, Sir James Black, has contributed to basic scientific and clinical knowledge in cardiology, both as a physician and as a basic scientist. His invention of propranolol, the beta adrenergic receptor antagonist that revolutionized the medical management of angina pectoris, is considered to be one of the most important contributions to clinical medicine and pharmacology of the 20th century. His method of research, his discoveries about adrenergic pharmacology, and his clarification of the mechanisms of cardiac action are all strengths of his work. In 1988, he was awarded the Nobel Prize in Medicine. Sir James's conclusions and method of research have continued to influence work in clinical pharmacology and cardiovascular medicine. Thus, the development of propranolol runs parallel to most other great achievements in medicine: the genius of a few builds on the accomplishments of many, and the discovery influences thinking long after the breakthrough has occurred.