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Last Updated: Wednesday, 28 June 2006, 09:55 GMT 10:55 UK
Q&A: Beta-blockers
Blood pressure being taken
High blood pressure affects 40% of adults

Guidelines issued by the NHS drugs watchdog have given new advice on which medicines should be used to treat high blood pressure.

They recommend that beta-blockers should no longer be routinely used, expect in special situations, but why have they made this decision and what does this mean?

What are beta-blockers?

Beta-blockers are a group of medicines which have been routinely used to treat high blood pressure, also known as hypertension, since the 1970s.

They are also given to relieve angina, correct irregular heartbeats, reduce the risk of dying after a heart attack and treat heart failure.

Beta-blockers go under different names, including: Acebutolol, Atenolol, Bisoprolol, Metoprolol, Oxprenolol, Pindolol, Propanaolol, Sotalol, and Timolol.

How many people take beta blockers?

About two million people in the UK are currently treated with beta-blockers for hypertension.

What do the new guidelines say?

The National Institute for Health and Clinical Excellence (NICE) and the British Hypertension Society (BHS) have issued new recommendations for treating high blood pressure.

They say that beta-blockers should not be used to treat high blood pressure, except in a few specific cases.

They point out that other drugs, called ACE inhibitors, calcium-channel blockers and diuretics, have been shown to be more effective at reducing the risk of stroke when compared with beta-blockers.

There is also increasing evidence that the most frequently used beta-blockers can carry a higher risk, some studies suggest up to 30% higher, of provoking type 2 diabetes than the new drugs. Many of the new medicines also have fewer side effects than beta-blockers.

Does this mean beta-blockers are dangerous?

The Blood Pressure Association says it is worth remembering there is no immediate risk to your health if you are taking beta-blockers, it is just that there are newer, more effective medicines that should be used instead.

What should I do if I am taking beta-blockers?

It is important not to stop taking your medication suddenly without consulting a doctor or nurse, especially if you have angina or have had a previous heart attack or heart failure, as in these circumstances beta-blockers are still thought to be one of the best forms of treatment.

The Blood Pressure Association says there is no need to make a special appointment to see your doctor, but you should talk to your doctor or nurse about your medication when you next have a routine appointment.

What will people with high blood pressure take instead?

Patients of African or Caribbean descent at any age, or patients over 55 should be initially treated with either a calcium channel blocker or a diuretic.

Patients younger than 55, should be given an ACE inhibitor as their first choice of initial therapy.

If these treatments do not lower blood pressure enough (the desired level is 140/90mmHg or less) then other combinations of the drugs should be used.

Who should still take beta-blockers?

Younger women who could get pregnant, those who cannot take ACE inhibitors, and those who have had a previous heart attack, chest pains, or heart failure.


SEE ALSO
Hypertension
23 Feb 06 |  Medical notes
Doubts over blood pressure drug
05 Nov 04 |  Health

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