Why have I been prescribed beta-blockers? How to use them well?

What is a beta blocker? What is his role ?

Beta-blockers, also called beta-blockers or beta-adrenergic blockers, are often used in cardiology. Administered orally, they relieve the heart by:

  • slowing the heart rate
  • lowering blood pressure
  • and reducing oxygen consumption.

They also have the ability to strengthen our heart muscle when it is weakened. In an emergency, they can also be injected intravenously.

List: what are the main beta-blocker drugs (cardioselective, non-selective, etc.)?

Several generations of beta-blocker drugs are currently available on the market.

We distinguish cardioselective beta-blockerswhich include:

  • acebutolol (Sectral®);
  • atenolol (Tenormine®);
  • bisoprolol (Cardensiel®);
  • celiprolol (Célectol®);
  • metoprolol (Lopressor®);
  • and nebivolol (Temerit®).

Non-selective beta-blockers, which include in particular:

  • carteolol (Mikelan®);
  • nadolol (Corgard®);
  • pindolol (Visken®);
  • propranolol (Avlocardyl®);
  • timolol (Timacor®);
  • and tertatolol (Artex®).

What is the “best” beta-blocker?

The most commonly used beta blocker is bisoprolol (Cardensiel®). Because ? It is relatively neutral, its handling is simple and its numerous dosages facilitate its prescription. Nevertheless, there is no “best” or “worst” beta-blocker. The choice of drug is discussed with the doctor according to each patient (age, pathology, history, etc.).

Beta-blockers, as their name suggests, block beta-adrenergic receptors on myocardial muscle cells in the sinus node. They thus prevent the action of catecholamines (adrenaline, noradrenaline and dopamine). Their effects can be numerous:

  • decrease in heart rate;
  • decrease in myocardial contractility;
  • slowing of intracardiac conduction;
  • decreased cardiac excitability;
  • decrease in oxygen consumption;
  • vasoconstriction;
  • bronchoconstriction;
  • hypoglycemic;
  • antihypertensive;
  • antiarrhythmic.

Beta-blockers can be prescribed by a general practitioner or a cardiologist.

  • The treatment must be followed to the letter and taken every day at regular intervals.
  • Take your heart rate and blood pressure every day.
  • In case of omission, do not take two doses or an extra dose of medicine.
  • Finally, do not stop your treatment under any circumstances. In case of side effects or abnormality, contact your doctor. Stopping beta-blockers, especially if they are prescribed in high doses, can generate an amplification of the pathology targeted by the treatment.

What are the risks of interaction?

Beta-blockers present little risk of interaction. However, they may interact with centrally acting antihypertensives and drugs containing diltiazem, verapamil or fingolimod.

Above all, do not forget to tell your doctor if you are taking an antiarrhythmic, an NSAID, an imipramine antidepressant, a neuroleptic, a calcium channel blocker, beta-blocker eye drops or a medicine containing dobutamine, isoprenaline or mefloquine.

Tachycardia, hypertension… What are the indications for these drugs?

Beta-blockers are mainly prescribed in case of cardiovascular disorders (tachycardia, arrhythmia, high blood pressure, myocardial infarction, heart failure or strokes). They can also be indicated:

  • in case of cardiovascular manifestations of hyperthyroidism ;
  • in prevention of digestive bleeding ;
  • in the background treatment for migraines and facial pain ;
  • in the management of essential tremors;
  • in the treatment of glaucoma(in the form of eye drops).

Beta-blockers also work against stress

When confronted with stress, our body produces adrenaline and noradrenaline, responsible for unpleasant manifestations (jitters, tremors, increased heart rate, etc.). Beta-blockers act precisely on the secretion of adrenaline and slow down the heartbeat. This is why they are sometimes popular. The molecule most commonly prescribed in the event of episodes of acute stress is propalonol (Avlocardyl®).

No sedative effect has yet been noted, unlike anxiolytic or psychotropic drugs. Beta-blockers are then prescribed in small doses, to limit the occurrence of side effects.

Beta-blockers are considered as doping products in precision sports, motorsport, ski jumping and in the various underwater disciplines in apnea. In question ? Their cardiac activity which allows the improvement of physical performance. They are so banned in many sports by the International Olympic Committee.

Side effects: what are the disadvantages and dangers of beta-blockers?

The establishment of treatment with beta-blockers requires a precise interrogation and the realization of an ECG (electrogram). Throughout the course of treatment, the patient should regularly monitor his pulse and blood pressure. Several side effects can occur:

  • fatigue ;
  • dizziness;
  • shortness of breath on exertion;
  • cold fingers and toes (Raynaud’s syndrome);
  • bradycardia (significant slowing of heart rate).

Digestive disorders (nausea, diarrhea, vomiting) may also occur. If they persist, talk to your doctor who may be able to review the prescription or dosage.

Which beta-blocker does not make you fat?

Beta-blockers unfortunately induce weight gain. Fact, they alter thermogenesis, a natural phenomenon that regulates body temperature by burning calories and body fat. By halving its effectiveness, they promote the storage of fat in the body, and therefore weight gain.

It is impossible to say whether a particular beta-blocker causes moderate or significant weight gain. On the other hand, this phenomenon can be countered thanks to food vigilance and the practice of a regular sporting activity. If appropriate, physicians may also attempt toadapt the prescription.

Contraindications: in which cases are beta-blockers not recommended? When to stop them?

Beta-blockers can cause a “rebound” effect and amplify the symptoms of the initial pathology when they are stopped. Also, they are formally not recommended for people suffering from:

  • decompensated heart failure ;
  • asthma ;
  • Where Prinzmetal angina.

Several relative contraindications must also be taken into account:

  • a chronic obstructive bronchopathy (COPD) (beta-blockers can destabilize chronic respiratory disease);
  • a Raynaud’s syndrome ;
  • a obliterating arteriopathy of the lower limbs ;
  • a diabetes (blockade of beta-adrenergic receptors may mask the signs of hypoglycaemia).
  • Finally, a myasthenia gravis can sometimes be aggravated by the administration of beta-blockers.

Otherwise, beta-adrenergic sensitivity decreases with age. Also, the dosages should be reviewed according to the patient’s age.

In pregnant women, beta-blockers should also be used under close supervision.

Can we consider natural alternatives?

It is important to remember that natural solutions do not replace beta-blockers. In case of arterial hypertension, according to the doctor’s recommendations, the decoctions of olive leaves, garlic or hawthorn can be interesting alternatives. Certain plants such as hawthorn, valerian, or even passionflower, can also be useful in case of stage fright or stress.

Leave a Comment