Beta Blockers

Beta blockers such as Atenolol, Bisoprolol, Metoprolol, and the like are prescribed as medication for high blood pressure, especially when there is a specific additional reason for it. This could be, for example, angina pectoris (feeling of tightness in the chest), post-myocardial infarction, heart failure, or the need for heart rate control.

What do beta blockers block?

Stress hormones such as adrenaline and noradrenaline increase the blood pressure and heart rate. Beta blockers prevent this by blocking the receptors used for this purpose - the so-called beta receptors (ß1 and ß2 receptors).

Beta1 receptors are primarily located in the heart. They lead to an increase in heart rate and cardiac output; after the release of adrenaline or noradrenaline, blood pressure rises.

Beta2 receptors are mainly found in the smooth muscle of blood vessels and the airways. When the muscle contracts, the blood vessels constrict, leading to an increase in blood pressure. This is a reaction that has been ingrained since ancient times to prepare the body for flight or fight. Back then, physical activity (flight or fight) would have followed, during which the stress hormones would have been broken down. This is usually no longer the case today, and as a result, tension can persist. Stress remains, causing both blood pressure and heart rate to rise.

Here, beta blockers intervene. By blocking these receptors, they cause a decrease in blood pressure and heart rate.

Additionally, beta blockers reduce the production of renin, which constricts blood vessels and thus increases blood pressure.

Beta blockers should never be discontinued on your own. Adherence to medication (Compliance) is essential to maintain the positive effects of beta blockers on blood pressure and the heart. Abruptly stopping the medication can lead to a rapid increase in blood pressure and heart rate (rebound phenomenon), dizziness, and/or angina pectoris. The risk of having a heart attack also increases again.

Therefore, beta blockers should always be "tapered off." This means that the dosage is slowly reduced according to the doctor's instructions.

Caution is also advised with alcohol in combination with beta blockers. Alcohol can enhance the effects and side effects.

Exercise is also possible with a beta blocker therapy. However, it should be discussed with the doctor to find a suitable training program.

But beware: In some sports, beta blockers are considered performance-enhancing substances.

Beta Blockers: Side Effects

Beta blockers lower heart rate, often cause fatigue, headaches, and gastrointestinal complaints. Some patients develop sleep disturbances, and men may experience impotence.

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

Beta Blockers: Medications

There are different types of beta blockers:

Selective beta blockers that specifically target the ß1 receptors, thus acting on the heart, e.g., Atenolol, Bisoprolol, Esmolol, Metoprolol, and are particularly suitable for lowering blood pressure
Non-selective ß-blockers that block both ß1 and ß2 receptors, e.g., Carvedilol, Pindolol, Propranolol, Sotalol
Third-generation beta blockers have additional effects, such as blocking other receptors or having rhythm-regulating effects, e.g., Carvedilol, Nebivolol, Sotalol

Sources:

By Sabine Croci. This article is medically reviewed. Last updated (02/2024).
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Beta Blockers

What do beta blockers block?

Beta Blockers: Side Effects

Beta Blockers: Medications

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