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Heart Disease and Beta-Blocker Therapy

Beta-blockers are one of the most widely prescribed classes of drugs to treat hypertension (high blood pressure) and are a mainstay treatment of congestive heart failure. Beta-blockers work by blocking the effects of epinephrine (adrenaline) and slowing the heart's rate, thereby decreasing the heart’s demand for oxygen. Long-term use of beta-blockers helps manage chronic heart failure.

Examples of beta-blockers include:

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Why Are Beta-Blockers Prescribed?

Beta-blockers are often prescribed for these heart conditions:

  • Heart failure
  • High blood pressure
  • Angina
  • Abnormal heart rhythms
  • Heart attack

In addition, beta-blockers are sometimes prescribed for glaucoma, migraine headaches, anxiety, certain types of tremors, and hyperthyroidism.

How Should I Take Beta-Blockers?

Beta-blockers can be taken in the morning, at meals, and at bedtime; taking them with food minimize side effects because absorption is slower. Follow the label directions on how often to take a beta-blocker. The number of doses you take each day,  the time allowed between doses, and how long you need to take the medication will depend on your condition. Ask your doctor what to do if you miss a dose. 

Beta-blockers should not be prescribed if you have low blood pressure or a slow pulse, because the further reduction in heart rate can cause dizziness and lightheadedness. If you have asthma or COPD, your doctor may not prescribe a beta-blocker because it may worsen symptoms. If you have heart failure and severe lung congestion, your doctor will treat your congestion before prescribing a beta-blocker.

While you are taking a beta-blocker, you may need to record your pulse every day. If your pulse is slower than it should be, contact your doctor about taking your beta-blocker that day.

Never stop taking a beta-blocker without speaking to your doctor first, even if you feel that it is not working. Sudden withdrawal can worsen angina and cause heart attacks.

What Are the Side Effects of Beta-Blockers?

Side effects of beta blockers include:

  • Fatigue
  • Cold hands
  • Headache
  • Upset stomach
  • Constipation
  • Diarrhea
  • Dizziness
  • Shortness of breath
  • Trouble sleeping
  • Loss of sex drive/erectile dysfunction
  • Depression

Side effects of beta-blockers are common and usually mild, but if these symptoms persist or become severe, contact your doctor:

Do Other Drugs Interact With Beta-Blockers?

A beta-blocker is often prescribed with a diuretic (''water pill''), or other medications such as ACE inhibitors and angiotensin receptor blockers (ARBs), which  lower blood pressure and improve heart failure symptoms. If you have side effects after taking your heart drugs together, contact your health care provider. You may need to change the times you take each medication.

It is important that your doctor is aware of all the drugs you are taking -- including over-the-counter drugs, herbs and supplements -- because they have the potential to interact with beta-blockers. 

Can Pregnant Women Take Beta-Blockers?

Use of beta-blockers during pregnancy may affect the growing fetus by slowing its heart rate, and lowering its blood sugar level and blood pressure. Beta-blockers can also pass to the infant through breast milk, causing low blood pressure, difficulty breathing and a slowed heart rate. 

Women should inform their doctor if they are trying to get pregnant or become pregnant while on beta-blockers or are breastfeeding. 

 

Can Children Take Beta-Blockers?

Certain beta-blockers have been used successfully in children to treat a variety of conditions, including heart failure, irregular heartbeat, high blood pressure, and migraines.

Can Older Adults Take Beta-Blockers?

Beta-blockers, usually in lower doses, are frequently prescribed to older people.

WebMD Medical Reference

Reviewed by Elizabeth Klodas, MD, FACC on February 19, 2014
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