New advice on blood-pressure drug

Around 40% of adults have high blood pressure

A class of drugs called beta-blockers should no longer be given to patients with high blood pressure, the NHS drugs watchdog for England and Wales says.

Other drugs are better at treating the condition, also known as hypertension, which affects 40% of adults, it says.

The new guidance from the National Institute for Health and Clinical Excellence says using beta-blockers also increases the risk of diabetes.

But patients on the drugs are urged to keep taking them until seeing their GP.

On Breakfast this morning

We talked to the co-author of the report, Professor Neil Poulter

We answered your questions with the Breakfast GP, Dr Rosemary Leonard

The key thing for people on Beta Blockers is to stay on them...those drugs have been doing them good for a long time Professor Neil Poulter Co-author of the report

Dr Poulter said that there are two main reasons for the guidance to be reviewed. The first, is that the newer drugs are more effective at protecting patients from heart attacks and strokes and secondly, Beta Blockers are more prone to causing diabetes.

Along with all the other experts, Dr Poulter said that there was no need to make a special visit to the GP, but that next time treatment is being reviewed, patients could then think about changing therapies.

Breakfast GP Dr Rosemary Leonard agreed that people should continue to take their tablets.

These are not brand new drugs, they've been around for years Dr Rosemary Leonard

She stressed that it was important for people to find out, from their GP, what drugs they were using before making any decisions. Many people, she said, would already be on the alternatives to Beta Blockers.

And Dr Rosemary said that many people with high blood pressure would not even know which type of drugs they're on. As a short guide, she said that drugs ending in "olol" - like atenolol are usually Beta Blockers, whereas those ending with "opril" are usually ACE inhibitors.

Dr Rosemary Leonard - advises people to talk to their GP

However, it's vital that patients talk to their GP - and Rosemary said that finding out which drugs you are taking can generally be done with a phone call to the surgery.

About 40% of adults in England and Wales have hypertension and in 2001, the NHS funded 90 million prescriptions for drugs which lower blood pressure.

Two million people in the UK are currently treated with Beta-blockers for hypertension.

The drugs are also used to treat heart failure and angina and should still be used for these problems.

But NICE now says the evidence suggests they perform less well than other drugs in treating high blood pressure, particularly in the elderly, and there is increasing evidence that they carry an "unacceptable risk" of provoking type 2 diabetes.

Instead doctors should use another class of drugs, adding in different ones if a patient's blood pressure remains high, it says.

Recommendations

Black patients of any age or patients aged over 55 in all other ethnic groupings should be treated with a class of drugs called calcium channel blockers or drugs called diuretics.

If a person's blood pressure remains too high - the target is 140/90mmHg - they can take a second group of drugs called ACE inhibitors and if they need further treatment the GP can add whichever of the three the person has yet to take.

NEW RECOMMENDATIONS In patients under 55, first drug should be an ACE inhibitor, followed by a calcium channel blocker or a diuretic, then all three In patients over 55, or black patients, first choice should be a calcium channel blocker or diuretic, followed by an ACE inhibitor, and then all three if necessary Beta-blockers should no longer be used for hypertension except in patients who need them for other reasons such as heart failure

Patients under the age of 55 years should start treatment with an ACE inhibitor.

Experts were quick to advise patients not to stop taking their medication and said a discussion should be undertaken with their GP at their next routine appointment.

Professor Graham MacGregor, chairman of the Blood Pressure Association, said: "High blood pressure is the most important preventable cause of death and disability in the UK.

"This is a major step forward. There are several million people on beta-blockers, but no one should stop their medication without advice.

"Probably 70 to 80%, over the course of the next year will be switched [to a newer drug] but it's not a panic situation."

We're afraid we can't deal with any more of your questions, as our programme has now finished. But you can watch our interviews again with Dr Rosemary Leonard on this page.

If you have any worries about your medication, don't stop taking it - but do book an appointment with your GP