Beta-blockers are a class of prescription medications commonly used to treat conditions related to your heart and blood vessels. For example, your healthcare provider may prescribe a beta-blocker to help lower your blood pressure or treat heart failure.
Beta-blockers are some of the most commonly prescribed drugs in the United States. According to the Centers for Disease Control and Prevention (CDC), about 22% of older Americans (ages 60 to 79) take a beta-blocker for high blood pressure or heart disease.
Some commonly prescribed beta-blockers are Lopressor (metoprolol), Tenormin (atenolol), and Coreg (carvedilol).
This article will discuss the uses and types of beta-blockers, how they work, how to take them safely, and their advantages versus disadvantages.
Uses of Beta-Blockers
Most beta-blockers are used to treat heart conditions, including:
Beta-blockers are also approved for other uses unrelated to your heart or blood vessels. These include:
Off-Label Uses
In addition to their Food and Drug Administration (FDA)–approved uses, sometimes beta-blockers are prescribed to treat conditions that differ from what the drug was initially approved to treat. This is called off-label use.
Certain beta-blockers are sometimes used off-label to treat:
How Do Beta-Blockers Work?
Your body uses chemicals called neurotransmitters to send messages to cells to act a certain way. Adrenaline (also called epinephrine) is an activating neurotransmitter naturally produced by the body.
When activated, adrenaline sends messages to increase heart rate, blood pressure, and the force with which the heart beats.
Beta-blockers attach to sites on cells called receptors that block the action of adrenaline. By blocking adrenaline, beta-blockers reduce heart rate, lower blood pressure, and decrease the force with which your heart pumps blood.
What Are Beta-Receptors and What Do They Do?
To work, beta-blockers must attach to sites throughout your body called beta-receptors. Different types of beta-receptors are located in several areas of your body and have various functions when activated.
Beta-1 Receptors
Beta-1 receptors are typically found in the heart and kidneys. Activating this type of receptor results in:
- Increased heart rate
- Increased heart pumping force
- Release of renin (an enzyme that helps raise blood pressure) from your kidneys
Beta-blockers that target beta-1 receptors help slow heart rate, lower blood pressure, and relieve chest pain.
Beta-2 Receptors
Beta-2 receptors are mainly located in the smooth muscle of your respiratory system, blood vessels, and nervous system.
Beta-blockers that attach to beta-2 receptors in the blood vessels help lower blood pressure by relaxing and widening your blood vessels. Beta-blockers that attach to beta-2 receptors in the nervous system help reduce tremors.
Other medications that target beta-2 receptors in the lungs are typically used to treat breathing conditions, such as asthma and chronic obstructive pulmonary disease (COPD). These drugs are not beta-blockers. Instead, they activate beta-receptors in the lungs.
Beta-3 Receptors
Beta-3 receptors are found in fat cells and your bladder. Activating beta-3 receptors results in fat cell breakdown and relaxation of your bladder. Because activating this receptor may also cause tremors, many medications don’t target beta-3 receptors.
Examples of Beta-Blockers
The table below shows examples of commonly prescribed beta-blockers and their uses.
Commonly Prescribed Beta-Blockers | ||
---|---|---|
Generic Names | Brand Names | Approved Uses |
Atenolol | Tenormin | High blood pressure; angina; heart attack |
Bisoprolol | — | High blood pressure |
Carvedilol | Coreg | High blood pressure; heart attack; heart failure |
Metoprolol | Lopressor Toprol XL | High blood pressure; angina; heart attack |
Labetalol | — | High blood pressure |
Nadolol | Corgard | High blood pressure; angina |
Nebivolol | Bystolic | High blood pressure |
Propranolol | Inderal LA; InnoPran XL | High blood pressure; angina due to coronary artery disease; atrial fibrillation (irregular heart rhythm); heart attack; migraine; essential tremor; enlarged heart; symptoms of pheochromocytoma (adrenal gland tumor) |
Timolol | Betimol; Timoptic; Istalol | Glaucoma |
What Are the Side Effects of Beta-Blockers?
As with all medications, beta-blockers may cause side effects in some people.
Side effects may vary based on which beta-blocker you take. But in general, many beta-blockers have similar common side effects. These can include:
In rare cases, beta-blockers may cause serious side effects, such as:
These lists do not reflect all the potential side effects of beta-blockers. Your healthcare provider can answer questions about side effects specific to your treatment and condition.
Who Shouldn’t Take Beta-Blockers?
Beta-blockers may not be for everyone. They may worsen or negatively affect certain health conditions.
Before you start taking a beta-blocker, let your healthcare provider know if:
- You have asthma.
- You have a condition or take medications that may cause low blood sugar level.
- You have Raynaud’s phenomenon.
- You have low blood pressure.
- You have a slow heart rate.
- You have certain conditions that affect your heart rhythm.
What to Avoid When Taking Beta-Blockers
Some medications may negatively affect beta-blockers. They may increase the risk of side effects from beta-blockers or affect how well they work.
Let your healthcare provider know if you take:
Your healthcare provider can help you decide if beta-blockers are a safe option for you.
In some cases, they may adjust the dose of your beta-blocker or another medication to reduce your risk of side effects. They may also monitor you more closely to check that your medications are working properly.
Advantages and Disadvantages of Beta-Blockers
As with all medications, beta-blockers have benefits and drawbacks.
If your healthcare provider is considering prescribing a beta-blocker, they’ll likely discuss some of the drug’s advantages and disadvantages with you. Below are a few examples.
Advantages and Disadvantages of Beta-Blockers
- Effective in treating several conditions
- Most common side effects are mild
- Generally inexpensive
- Can potentially be lifesaving after a heart attack
- May cause sexual side effects, such as erectile dysfunction
- May worsen depression
- May worsen certain heart rhythm conditions
- Must be used cautiously or not at all if you have diabetes or asthma
Alternatives to Beta-Blockers
While beta-blockers are effective in treating several heart conditions, they may not be right for everyone. If you have a health condition or take other medications that may be negatively affected by beta-blockers, your healthcare provider may recommend alternatives to beta-blockers.
Below are examples of medications your healthcare provider may prescribe instead of beta-blockers. They may also suggest other natural methods and lifestyle changes to help keep your heart healthy.
Drugs That Slow Heart Rate and Lower Blood Pressure
Beta-blockers slow your heart rate and lower blood pressure. The following medications are beta-blocker alternatives that can have the same effects:
- Cardizem (diltiazem)
- Verelan (verapamil)
- Corlanor (ivabradine)
Natural Ways to Lower Your Blood Pressure
Some supplements and herbs are thought to act like beta-blockers. In some studies, they have been found effective in reducing blood pressure or regulating heart rhythm.
However, it’s important to remember these drugs should not be used as a substitute for healthy lifestyle changes or medication if necessary.
Examples include:
It’s important to talk with your healthcare provider before taking any supplements or herbs. Many of them have side effects or interact with other medications. Your pharmacist or provider can let you know if any of these are safe for you to take.
Lifestyle Changes for Healthy Blood Pressure
Even if you take beta-blockers or other medications to help lower your blood pressure or manage your heart condition, you can also implement healthy lifestyle changes to help keep your heart healthy.
The American Heart Association recommends the following lifestyle changes to help with healthy weight loss, which can help lower your blood pressure and reduce your risk of heart-related conditions:
Summary
Beta-blockers are commonly prescribed to help lower blood pressure and slow down heart rate. Some beta-blockers are also approved to treat other conditions, such as glaucoma and migraine headaches.
Examples of beta-blockers include Toprol XL (metoprolol), Inderal LA (propranolol), and Timoptic (timolol).
Beta-blockers work by attaching to beta-receptors in your body and blocking the action of adrenaline in these sites. Depending on where the receptors are located, the action of beta-blockers can relax your blood vessels, relieve chest pain, or reduce tremors.
Most common side effects of beta-blockers are mild. However, beta-blockers may worsen certain health conditions, including asthma, Raynaud’s phenomenon, and depression. They may also interact with some medications, such as NSAIDs and medications for diabetes.
Talk with your healthcare provider if you want to learn more about beta-blockers. They can help you decide whether these drugs are effective and safe for your condition.