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Beta Blockers to Lower Blood Pressure

Beta blockers help your heart beat slower and with less force. Your heart pumps less blood through the blood vessels, and your blood pressure goes down. Beta-blockers work by affecting the response to some nerve impulses in certain parts of the body. As a result, they decrease the heart's need for blood and oxygen by reducing its workload. They also help the heart to beat more regularly.

Beta-adrenergic blocking agents are available only with your doctor's prescription. This group of medicines is known as beta-adrenergic blocking agents, beta-blocking agents, or, more commonly, beta-blockers. Beta-blockers are used in the treatment of high blood pressure (hypertension). Some beta-blockers are also used to relieve angina (chest pain) and in heart attack patients to help prevent additional heart attacks. Beta-blockers are also used to correct irregular heartbeat, prevent migraine headaches, and treat tremors. They may also be used for other conditions as determined by your doctor.

Proper Use of This Medicine

Ask your doctor about checking your pulse rate before and after taking beta-blocking agents. If your doctor tells you to check your pulse regularly while you are taking this medicine, and it is much slower than the rate your doctor has designated, check with your doctor. A pulse rate that is too slow may cause circulation problems.

Remember that this medicine will not cure your high blood pressure but it does help control it. It is very important that you take your medicine exactly as directed, even if you feel well. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. Also, it is very important to keep your appointments with your doctor, even if you feel well.

Beta Blocker Reference

Beta-blockers

Atenolol (Tenormin†)

25-100

1

Betaxolol (Kerlone†)

5-20

1

Bisoprolol (Zebeta†)

2.5-10

1

Metoprolol (Lopressor†)

50-100

1-2

Metoprolol Extended Release (Toprol Xl)

50-100

1

Nadolol (Corgard†)

40-120

1

Propranolol (Inderal†)

40-160

2

Propranolol Long-Acting (Inderal La†)

60-180

1

Timolol (Blocadren†)

20-40

2

BBs w/ intrinsic acebutolol

Acebutolol (Sectral†)

200-800

2

sympathomimetic activity

Penbutolol (Levatol)

10-40

1

Pindolol (Generic)

10-40

2

Combined alpha- and BBs

Carvedilol (Coreg)

12.5-50

2

Labetalol (Normodyne, Trandate†)

200-800

2

 

Precautions & Side Effects. Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

This medicine may cause some people to become dizzy, drowsy, or lightheaded. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert. If the problem continues or gets worse, check with your doctor.

Beta-blockers may make you more sensitive to cold temperatures, especially if you have blood circulation problems. Beta-blockers tend to decrease blood circulation in the skin, fingers, and toes. Dress warmly during cold weather and be careful during prolonged exposure to cold, such as in winter sports.

Beta-blockers may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn.

Chest pain resulting from exercise or physical exertion is usually reduced or prevented by this medicine. This may tempt a patient to be overly active. Make sure you discuss with your doctor a safe amount of exercise for your medical problem.

Check with your doctor as soon as possible if any of the following side effects occur:

  • Less common – Breathing difficulty and/or wheezing;  cold hands and feet;  mental depression;  shortness of breath;  slow heartbeat (especially less than 50 beats per minute);  swelling of ankles, feet, and/or lower legs 
  • Rare – Back pain or joint pain;  chest pain ;  confusion (especially in elderly patients);  dark urine—for acebutolol, bisoprolol, or labetalol;  dizziness or lightheadedness when getting up from a lying or sitting position;  fever and sore throat;  hallucinations (seeing, hearing, or feeling things that are not there);  irregular heartbeat;  red, scaling, or crusted skin;  skin rash;  unusual bleeding and bruising;  yellow eyes or skin—for acebutolol, bisoprolol, or labetalol 
  • Signs and symptoms of overdose (in the order in which they may occur) – low heartbeat;  dizziness (severe) or fainting;  fast or irregular heartbeat;  difficulty in breathing;  bluish-colored fingernails or palms of hands;  convulsions (seizures)  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Before Using This Medicine. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For the beta-blockers, the following should be considered:

Allergies –Tell your doctor if you have ever had any unusual or allergic reaction to the beta-blocker medicine prescribed. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy –Use of some beta-blockers during pregnancy has been associated with low blood sugar, breathing problems, a lower heart rate, and low blood pressure in the newborn infant. Other reports have not shown unwanted effects on the newborn infant. Animal studies have shown some beta-blockers to cause problems in pregnancy when used in doses many times the usual human dose. Before taking any of these medicines, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding – It is not known whether bisoprolol, carteolol, or penbutolol passes into breast milk. All other beta-blockers pass into breast milk. Problems such as low blood sugar, slow heartbeat, low blood pressure, and trouble in breathing have been reported in nursing babies. Mothers who are taking beta-blockers and who wish to breast-feed should discuss this with their doctor.

Children – Some of these medicines have been used in children and, in effective doses, have not been shown to cause different side effects or problems in children than they do in adults.

Older adults – Some side effects are more likely to occur in the elderly, who are usually more sensitive to the effects of beta-blockers. Also, beta-blockers may reduce tolerance to cold temperatures in elderly patients.

Other medicines – Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary.

Other medical problems – The presence of other medical problems may affect the use of the beta blockers. Make sure you tell your doctor if you have any other medical problems.


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