Your body on a beta-blocker

When it comes to matters of the heart, beta-blockers such as atenolol (Tenormin®) are some of the most-loved medications, and for good reason. They’re just about the hardest-working medications around. Beta-blockers may be used to treat high blood pressure and chest pain. Plus: “They’ve been shown to improve survival and prevent life-threatening heart rhythm problems in patients who have had a heart attack or those with heart failure,” says Jeffrey Goldberger, MD. He is the chief of the cardiovascular division and professor of medicine at the University of Miami Miller School of Medicine in Florida.

Boning up on the benefits of beta-blockers

Beta-blockers can treat a range of both acute and chronic conditions, including:

• Rapid heartbeat
• High blood pressure
• Heart attack
• Abnormal heart rhythms
• Coronary artery disease
• Congestive heart failure

In fact, these potent medications are considered one of the most effective treatments for congestive heart failure. This condition occurs when the heart isn’t able to pump as well as it should. It can cause swelling in the legs and lead to fluid buildup in the lungs. (That’s the “congestive” part.)

To fully understand how beta-blockers such as atenolol work, first you need to know about beta-receptors. These are tiny proteins that live on the outer surface of many cells in specific areas of the body. When the nervous system sends out certain chemical messengers, such as adrenaline, the role of beta-receptors is to attach to them. When this occurs, the body reacts by kicking important functions into overdrive: The heart beats faster, blood vessels constrict, airways relax, and the kidneys increase the production of a protein that boosts blood pressure.

Now enter beta-blockers. They come to the rescue by attaching to beta-receptors, stopping those chemical messengers from binding to their receptors. Now all of those processes that were in overdrive start to take it easy. The heart stops working so hard, and heart rate slows. Electrical signals in the heart are more efficient, blood vessels relax, and blood pressure lowers. (Learn how you can get your heart medication for less with Optum Perks. Download our discount card now.)

Here are a few more ways they help:

1. Beta-blockers can keep your heart from reacting too strongly to stress hormones such as adrenaline, says Dr. Goldberger. That protection is important when the heart is already weakened, such as after a heart attack or from heart failure.
2. Over time, they may also help your heart pump more efficiently, although experts aren’t sure why.
3. Beta-blockers can block the effects of stress and anger in people prone to atrial fibrillation (afib), according to a study in the journal HeartRhythm. Afib can cause an irregular, rapid heart rate that may cause palpitations, fatigue and shortness of breath.

Finding the beta-blocker that’s right for you

There are many different types of beta-blockers to choose from. “They don’t all have the same effects,” Dr. Goldberger says. “Doctors need to know which kind of beta-blocker is most suitable for each condition.”

A beta-blocker such as atenolol, for example, is known as “cardioselective.” That means it was designed to only block one type of receptor (beta-1), within heart cells. Some can affect beta-2 receptors, which are found in blood vessels and the lungs. Cardioselective types are generally considered safer for those with lung problems.

“As with any medication, beta-blockers may have side effects,” Dr. Goldberger says. “One of the more common ones is fatigue, although most people tolerate beta-blockers extremely well,” he says.

A few other common side effects include:

• Weight gain
• Tingling or coldness in the hands and feet
• Shortness of breath
• Headache
• Upset stomach

Naturally, the lower the dose, the less chance of noticeable side effects. “Emerging data is showing that the high doses of beta-blockers used in the (original) clinical trials may not be necessary in all situations,” says Dr. Goldberger. Some people may have the same benefits by taking just 25% of the dose used in those studies, he says.Either way, it’s important to take your beta-blocker as directed by your doctor. Stopping abruptly can cause rebound chest pain. And although it’s uncommon, it can also trigger a heart attack, stroke or erratic heart rhythm. Always talk to your doctor about stopping any medication. Generally, gradually decreasing the dosage can help prevent complications. But again: Always make medication changes under the supervision of your provider.

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