Beta-blockers are medications that doctors use to treat health conditions such as high blood pressure and arrhythmia.
They work by blocking the effects of certain hormones, such as adrenaline, on the heart to slow the heartbeat and lower blood pressure. Another benefit of beta-blockers is that they also help reduce anxiety symptoms.
Heart rhythm
Doctors consider beta-blockers as the first-line treatment in many acute and chronic conditions affecting the heart.
This includes heart rhythm disorders, called heart arrhythmia, when electrical pulses in the heart are unable to work properly, causing your heart to beat either too slowly or too fast.
A 2022 review concludes that beta-blockers are among the most essential medications for managing heart rhythm disorders.
Beta-blockers can reduce the effect of the sympathetic nervous system on the heart and slow down the heart rate. They can help relieve arrhythmia symptoms, such as chest pain (angina), shortness of breath, palpitations, and fatigue.
Arrhythmias can lead to complications, such as damage to your heart, stroke, or cardiac arrest. Some research also finds an increased risk of dementia in people with atrial fibrillation, a form of arrhythmia. Treatment with beta-blockers can reduce your risk of experiencing these complications.
Blood pressure
Doctors commonly use beta-blockers to lower your blood pressure. This happens through different mechanisms. They block the effect of adrenaline on your heart, which helps slow down your heartbeat with less force. Beta-blockers help improve blood flow by widening your veins and arteries.
Healthcare professionals do not consider beta-blockers as a first line of treatment for hypertension. They typically use them in combination with diuretics when only diuretics are ineffective in lowering blood pressure.
Hypertension can lead to severe complications, including heart disease, heart attack, and stroke. Managing hypertension can prevent these complications, so beta-blockers have some benefits here.
Anxiety
Beta-blockers also have an off-label use for the treatment of anxiety. Off-label means that the Food and Drug Administration (FDA) has not approved a drug for a particular use, but doctors can legally prescribe them if there is evidence that they can be effective for this purpose.
It’s important to note that while beta-blockers can’t address the psychological cause of anxiety, they may help with the physical symptoms of anxiety. Doctors typically prescribe them for short-term or for one-off events.
For example, musicians may use them before an important performance or audition to reduce stage fright symptoms such as a beating heart, shaky voice, or dizziness.
They help control the body’s fight-or-flight response by preventing adrenaline from attaching to the heart’s beta-receptors. This inhibits the effects on the sympathetic nervous system during acute moments of stress.
The most common beta-blocker for anxiety is propranolol (Inderal), which is typically used short term to reduce performance anxiety and stage fright.
Examples
The three main types of beta-blockers include:
- Cardioselective beta-blockers: True to their name, cardioselective beta-blockers focus only on the beta-1 receptors in the heart cells. They have fewer side effects, particularly for people with lung conditions. Examples of these drugs include acebutolol (brand name Sectral), atenolol (brand name Tenormin), and bisoprolol (brand name Zebeta).
- Third-generation beta-blockers: They are the latest to be developed and have additional benefits, such as improving insulin resistance. Examples of third-generation beta-blockers include carvedilol (Coreg), labetalol (Normodyne), and nebivolol (Bystolic).
- Nonselective beta-blockers: They work on all the beta-receptors in the body. As such, they are the ones that have the most side effects. Examples of nonselective beta-blockers include nadolol (Corgard) and propranolol (Inderal).
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