Beta-blockers for high blood pressure

Examples

Generic Name	Brand Name
acebutolol	Sectral
atenolol	Tenormin
betaxolol	Kerlone
carvedilol	Coreg
labetalol	Normodyne, Trandate
metoprolol	Lopressor, Toprol XL
nadolol	Corgard
penbutolol	Levatol
pindolol	Visken
propranolol	Inderal
	timolol

How It Works

Beta-blockers lower the heart rate, the amount of blood the heart pumps out, and the force of the heart beat, all of which lower blood pressure.

For high blood pressure, most beta-blockers are taken once or twice a day. They may be combined with a diuretic in the same pill.

Why It Is Used

Beta-blockers are widely used for high blood pressure, either alone or combined with other medicines including diuretics, ACE inhibitors, or calcium channel blockers. These medicines may be especially useful in people who also have angina or who have had a heart attack, small aortic aneurysms, migraine headaches, or an anxiety disorder.

In general, most medicines from this class are to be used carefully in people who have heart failure or certain types of irregular heartbeats (arrhythmias). Some experts recommend that these medicines should not be used in an older person with high blood pressure, because the medicines may reduce the cardiac output of an older person's heart.

Beta-blockers may require close monitoring in people who also have asthma, chronic obstructive pulmonary disease (emphysema), or diabetes. Some beta-blockers may make symptoms of lung disease worse and may affect how the body responds to low blood sugar.

How Well It Works

Beta-blockers lower blood pressure. Lowering blood pressure helps to lower the risk of heart disease, heart attack, and stroke.

For people who have already had a heart attack, beta-blockers may lower the risk of another heart attack and sudden cardiac death.

Side Effects

Side effects may include:

• Making asthma worse (some types of beta-blockers).
• Slow heart rate.
• Nightmares.
• Confusion.
• Decreased HDL (high-density lipoprotein), which is the "good" cholesterol.
• Increased blood sugar levels.
• Erection problems.
• Rapid heart rate and high blood pressure if medicine is withdrawn suddenly.

Beta-blockers also may:

• Mask warning signs of low blood sugar in people who have diabetes.
• Limit the endurance of a person who exercises (because they slow the heart rate).

Some people feel tired when they take beta-blockers. Depression is another possible side effect. If these or any other side effects are bothersome, tell your health professional. Certain beta-blockers affect tissues in the body differently and so may be less likely to cause certain side effects. If side effects are a problem with one medicine, a different one may be substituted.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

In people who also have an anxiety disorder, beta-blockers may be a good first choice for high blood pressure treatment.

Combining a low-dose diuretic with a beta-blocker medicine may enhance the medicine's blood pressure-lowering effects without causing other side effects.

It is important to take high blood pressure medicines daily as prescribed. Because high blood pressure often has no symptoms, it is easy to forget to take the pills.

If your high blood pressure medicine causes erection problems, you may want to talk to your doctor about erection-enhancing medicines such as sildenafil (Viagra).

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

Author:	Robin Parks, MS	Last Updated April 24, 2007
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Robert A. Kloner, MD, PhD - Cardiology Ruth Schneider, MPH, RD - Diet and Nutrition
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