Preventive Cardiology: Beta-blockers

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  • Common Names

    Examples of beta-blockers include:
    • Metoprolol (Lopressor, Toprol XL)
    • Propranolol (Inderal)
    • Atenolol (Tenoretic)
    • Carvedilol (Coreg)
    • Nadolol (Corgard)
    • Labetalol (Trandate)
    • Acebutolol (Sectral)
  • Current Uses

    Treatment
    Beta-blockers may be prescribed if you have:
    Prevention
    Beta-blockers may be prescribed to:
    • Reduce your risk of death from heart attack
    • Protect the heart if you have coronary artery disease
    • Reduce your risk of stroke
    • Protect the heart before surgery if you are at high risk of complications
  • Mechanism for How It Works

    Beta-blockers block the effects of adrenaline on your body's beta-receptors. This slows the nerve impulses that travel through the heart. As a result, your heart does not have to work as hard because it needs less blood and oxygen. This decreases heart rate, and blood pressure. Beta-blockers also block the impulses that can cause an arrhythmia.
    Beta-blockers generally work by affecting the response to some nerve impulses. Your body has two main beta-receptors: beta 1 and beta 2. Some beta-blockers are selective, which means that they block beta 1 receptors more than they block beta 2 receptors. Beta 1 receptors are responsible for heart rate and the strength of your heartbeat. Nonselective beta-blockers block both beta 1 and beta 2 receptors. Beta 2 receptors are responsible for the function of your smooth muscles (muscles that control body functions but that you do not have voluntary control over).
  • Side Effects

    Drug Interactions
    There are many types of medicines, herbs, and supplements that can affect how beta-blockers work. Since there are many different kinds of beta-blockers, drug interactions will vary depending on the specific medicine that you are prescribed. Before you begin taking a beta-blocker, talk to your doctor about all of the prescription medicines, over-the-counter products, and supplements that you are taking.
    Other Potential Concerns
    If you have certain conditions, you may not be able to take some types of beta-blockers. For example, if you have asthma or chronic obstructive pulmonary disease (COPD), certain beta-blockers may make your symptoms worse. This class of drugs may also affect diabetes, heart block, peripheral arterial disease , and other conditions. If you are pregnant or nursing, it is important to discuss the risks of taking a beta-blockers with your doctor.
    Talk to your doctor about your condition and any concerns that you have about taking beta-blockers.
    Side Effects
    Side effects include but are not limited to:
    • Drowsiness or fatigue
    • Cold hands and feet
    • Weakness or dizziness
    • Trouble sleeping
    • Loss of sex drive
    • Depression
  • RESOURCES

    American Heart Association http://www.heart.org/

    US Food and Drug Administration http://www.fda.gov/

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

    Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/splash/

    References

    Acebutolol. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated October 22, 2012. Accessed December 13, 2012.

    Atenolol. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated November 6, 2012. Accessed December 13, 2012.

    Beta blockers. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated January 2, 2012. Accessed December 13, 2012.

    Cardiac Medications. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/PreventionTreatmentofHeartAttack/Cardiac-Medications%5FUCM%5F303937%5FArticle.jsp. Updated September 10, 2012. Accessed December 13, 2012.

    2/11/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Salpeter S, Ormiston T, Salpeter E. Cardioselective beta-blockers for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2011;(1):CD003566.

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