Beta-blockers

How beta-blockers work for high blood pressure

Beta-blockers such as Atenolol, Bisoprolol, Metoprolol and others are prescribed as a medication for high blood pressure, especially when there is a specific additional reason. Examples include angina pectoris (a feeling of chest tightness), after a heart attack, heart failure, or the need to control the heart rate.

What do beta-blockers block?

Stress hormones like adrenaline and noradrenaline raise the blood pressure and the heart rate. Beta-blockers prevent this by blocking the receptors involved the so-called beta receptors (1 and 2 receptors).

Beta-1 receptors are found mainly in the heart. When they are activated, heart rate and cardiac output increase; after adrenaline or noradrenaline is released, blood pressure rises.

Beta-2 receptors are mainly located in the smooth muscle of blood vessels and airways, among other places. When the muscle tightens, the vessels constrict and blood pressure goes up. This is an ancient response to prepare the body for fight or flight. In the past this would have been followed by physical activity (flight or fight), which reduced the stress hormones. Today that usually doesn't happen, so the tension can remain. The ongoing stress keeps both blood pressure and heart rate elevated.

Here is where beta-blockers act. By blocking these receptors they lower blood pressure and heart rate.

Beta-blockers also reduce the production of renin, which narrows blood vessels and thus increases blood pressure.

Never stop taking beta-blockers on your own. Adherence (adherence) is essential to keep the beneficial effects of beta-blockers on blood pressure and the heart. Abruptly stopping the medication can cause a rapid rise in blood pressure and pulse (rebound phenomenon), dizziness and/or angina pectoris. The risk of having a heart attack can also increase again.

Therefore beta-blockers should always be tapered off. That means the dose is slowly reduced according to your doctor's instructions.

Be careful with alcohol while taking beta-blockers. Alcohol can increase both their effects and side effects.

Exercise is also possible while on beta-blocker therapy. It should be discussed with your doctor to find a suitable training program.

But be aware: In some sports beta-blockers are considered doping substances.

Beta-blockers: Side effects

Beta-blockers lower the heart rate and often cause tiredness, headache and gastrointestinal complaints. Some patients develop sleep problems, and men may experience impotence.

In patients with asthma, certain beta-blockers can lead to life-threatening situations.

Beta-blockers: Medications

There are different types of beta-blockers:

Selective beta-blockers that specifically target 1 receptors, so they act mainly on the heart, e.g. Atenolol, Bisoprolol, Esmolol, Metoprolol, and are especially suitable for lowering blood pressure
Non-selective -blockers that block both 1 and 2 receptors, e.g. Carvedilol, Pindolol, Propranolol, Sotalol
Third-generation beta-blockers have additional effects, such as blocking other receptors or stabilizing heart rhythm, e.g. Carvedilol, Nebivolol, Sotalol

Wirkstoff	Produkte
Atenolol	AteHexal, Atenogamma, Atenolol, Bresben Kombipräparat, Juvental, Nif-Ten Kombipräparat, Nifatenol Kombipräparat, Teneretic Kombipräparat, Tenoretic Kombipräparat, Tenormin, TRI-Normin Kombipräparat
Bisoprolol	Biramlo Kombipräparat, Biso Lich, Biso-Henning, Bisobeta, BisoDipin Kombipräparat, Bisogamma, BisoHexal, BisoLich Kombipräparat, Bisoplus Kombipräparat, Bisoprolol, Concor, Jutabis
Carvedilol	Carve TAD, Carve-Q, Carvedi-Denk, Carvedigamma, Carvedilol, Dilatrend, Querto
Celiprolol	Celipro, Celitin, Selectol
Esmolol	Brevibloc, Esmocard, Esmolol
Metoprolol	Belnif Kombipräparat, Beloc-Zok, Implicor, Jutabloc, Logimat Kombipräparat, Logimax Kombipräparat, Logroton, Lopresor, Meto-Henning, Meto-Succinat, Meto-Tablinen, Metobeta, Metodura, MetoHexal, Metoprogamma, Metoprolol, Metoprololsuccinat, Metoprololtartrat, Metostad, Mobloc Kombipräparat, Prelis, Seloken
Nebivolol	Nebilet, Nebivolol
Pindolol	Visken
Propranolol	Beta-Turfa Kombipräparat, Dociretic, Dociton, Hemangiol, Inderal, Obsidan, Pertenso, Propra, Propranolol
Sotalol	Darob, Renibloc, Sotabeta, Sotagamma, SotaHexal, Sotalex, Sotalol

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This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands monitor their blood pressure every day. Our content is based on carefully researched, evidence-based data and is continuously updated (as of 02/2024).

Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.

We hope you found the article helpful. For good blood pressure control, it's important to take your medications correctly. Our app BloodPressureDB will gladly remind you when to take them. It also keeps track of your medication supply and notifies you in time when you're running low. This feature is fully available in the free version as well. Get the free app now.

Beta-blockers

What do beta-blockers block?

Beta-blockers: Side effects

Beta-blockers: Medications

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