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Health Conditions > Hypertension >
Beta Blockers
Beta Blockers
Click here for why I feel that Micardis®
(telmisartan) should be the first line treatment for hypertension.
Related Topics:
Alternative News:
News & Research:
-
Nebivolol: New Beta-Blocker for Hypertension - US Pharmacist
-
Beta-blockers in Atrial
Fibrillation—Trying to Make Sense of Unsettling Results - Europace.
2023;25(2):260-262 - "There are no long-term safety and
efficacy data for beta-blockers in the treatment of atrial fibrillation and
there are several emerging concerns regarding their use. Considering the
uncertain evidence basis, the known unfavourable side-effect profile, and the
availability of alternative medications we avoid beta-blockers in patients with
atrial fibrillation in the absence of a clear and specific indication. When
considering the high prevalence of atrial fibrillation, there is an urgent need
for larger randomized outcomes trials that compare rate-control strategies"
-
Treatment with β-blocker
nebivolol ameliorates oxidative stress and endothelial dysfunction in tenofovir-induced
nephrotoxicity in rats - Front Med (Lausanne) 2022 Aug 4 -
"Tenofovir disoproxil fumarate (TDF), a widely
prescribed component in antiretroviral regimens, has been associated with
nephrotoxicity. Nebivolol is a third generation selective β-1 adrenergic
receptor blocker and may protect renal structure and function through the
suppression of oxidative stress and enhancement of nitric oxide (NO) synthesis
... Nebivolol holds multifaceted actions that promote an advantageous option to
slow the progression of kidney injury in tenofovir-induced nephrotoxicity"
-
Effects of Metoprolol on
Exercise Hemodynamics in Patients With Obstructive Hypertrophic Cardiomyopathy
- J Am Coll Cardiol 2022 Apr 26 - "The relationship
between exercise hemodynamics, loading conditions, and medical treatment in
patients with obstructive hypertrophic cardiomyopathy (HCM) is incompletely
understood ... No treatment effect on ΔPCWP was observed between metoprolol and
placebo treatment" - Note: It seems like beta-blockers are overrated
among cardiologists. With BB, the cure is worse than the disease. That's my
opinion but don't take it as medical advice.
-
A Systematic Review and
Network Meta-Analysis of Pharmacological Treatment of Heart Failure With Reduced
Ejection Fraction - Medscape, 3/21/22 - "In patients
with HF with reduced ejection fraction, the estimated aggregate benefit is
greatest for a combination of ARNi, BB, MRA, and SGLT2i"
-
Nebivolol and incident
cardiovascular events in hypertensive patients compared with nonvasodilatory
beta blockers - J Hypertens 2022 Feb 23 - "nebivolol
was associated with 17% reduction in incident cardiovascular events compared
with all nonvasodilatory beta blockers [hazard ratio 0.83, 95% confidence
interval (CI) 0.74-0.94, P = 0.004], and 24% reduction compared with metoprolol
... The vasodilatory beta blocker nebivolol was associated with reduced incident
cardiovascular events compared with nonvasodilatory beta blockers. Additional
study of other beta blockers is necessary to determine if this is a vasodilatory
beta blocker class effect or is specific to nebivolol" - Note: Nebivolol
is a third generation beta-blocker. Many cardiologists will tell you that they
will only prescribe three brands of beta-blockers because they're the only ones
that have been tested for heart failure. Those three just happened to be the
first generation which have the most side effects as if the third generation
didn't have enough side effects. I've never bought off on their logic but I'm
not a doctor. The studies I've seen show that the third generation, with the
less side effects, also work better. That said, all beta-blockers have
intolerable side effects. If the first generation has so many side effects that
the patients don't take them, then that's another reason for choosing nebivolol.
Nebivolol is also by far the most expensive. I'd bet those doctors would be
singing a different tune if they were the ones living with the side effects.
I've got PVCs and I'm waiting for
ablation to fix it. I still refuse even the third generation of beta-blockers.
They're all the ultimate torture. You're exhausted yet you can't sleep. I've
been watching a lot of YouTube videos on it. Lotta people even in their 20s and
30s have that problem: https://youtu.be/gdsUtSJZMVE
https://youtu.be/_Z-T9b1a0uo
https://youtu.be/fvjl1d8zv7k
https://youtu.be/r4H0nd9UJd0 . See
nebivolol at ReliableRxPharmacy.
-
Beta-Blocker Use in
Hypertension and Heart Failure (A Secondary Analysis of the Systolic Blood
Pressure Intervention Trial) - Am J Cardiol 2021 Dec 11 -
"Given the concern that beta-blocker use may be
associated with an increased risk for heart failure (HF) in populations with
normal left ventricular systolic function, we evaluated the association between
beta-blocker use and incident HF events, as well as loop diuretic initiation in
the Systolic Blood Pressure Intervention Trial (SPRINT) ... Subjects on a beta
blocker for the entire trial duration were compared with subjects who never
received a beta blocker after 1:1 propensity score matching. A competing risk
survival analysis by beta-blocker status was performed to estimate the effect of
the drug on incident HF and was then repeated for a secondary end point of
cardiovascular disease death. Among the 3,284 propensity score-matched subjects,
beta-blocker exposure was associated with an increased HF risk (hazard ratio
5.86; 95% confidence interval 2.73 to 13.04; p <0.001). A sensitivity analysis
of propensity score-matched cohorts with a history of coronary artery disease or
atrial fibrillation revealed the same association (hazard ratio 3.49; 95%
confidence interval 1.15 to 10.06; p = 0.028). In conclusion, beta-blocker
exposure in this secondary analysis was associated with increased incident HF in
subjects with hypertension without HF at baseline"
-
Are Long-Term Beta
Blockers Following MI in the Absence of Angina and HF Indicated in the PCI Era?
- Medscape, 12/8/21 - "Therefore, in older adults who
are completely revascularized and have no LV dysfunction or residual angina,
long term BB therapy should be reassessed after 3 months since these drugs may
cause adverse effects with no appreciable long-term benefits"
-
Certain beta blockers (e.g.,
bisoprolol) may be reevaluated in hypertension guidelines for patients with left
ventricular hypertrophy to diminish the ventricular arrhythmic risk - J Hum
Hypertens 2021 Mar 2 - "Hypertensive left ventricular
hypertrophy (HTN LVH) is associated with almost threefold increased risk of
ventricular tachycardia (VT)/ventricular fibrillation (VF). Furthermore, HTN LVH
increases the risk of sudden cardiac death (SCD). The reverse LV remodeling due
to efficient antihypertensive therapy lowers the incidence rates of
cardiovascular events and SCD and the vast majority of available arterial
hypertension (HTN) guidelines recommend renin angiotensin system (RAS) blockers
and calcium channel blockers (CCBs) for HTN LVH aiming for LVH regression. On
the other hand, beta blockers (BBs) as a class are not recommended in HTN LVH
due to their insufficient capacity to reverse LVH remodeling even though they
are recommended as the first-line drugs for prevention/treatment of VT/VF (in
general, unrelated to HTN LVH). Moreover, BBs are the best antiarrhythmic
(against VT/VF) among antihypertensive drugs. Despite that, BBs are currently
not recommended for LVH treatment in HTN Guidelines. It is important to prevent
VT/VF in patients at high risk, such as those with HTN LVH. Therefore, certain
BBs (such as Bisoprolol) may be reevaluated in guidelines for HTN (in the
section of HTN LVH)"
-
Nebivolol is more effective
than atenolol for blood pressure variability attenuation and target organ damage
prevention in L-NAME hypertensive rats - Hypertens Res 2021 Feb 22 -
"β-Adrenergic blockers are no longer recommended as
first-line therapy due to the reduced cardioprotection of traditional β-blockers
compared with other antihypertensive drugs. It is unknown whether
third-generation β-blockers share the limitations of traditional β-blocker ...
Nebivolol had a greater ability than atenolol to decrease central SBP and
mid-term and short-term blood pressure variability (BPV) in L-NAME rats.
Echocardiographic analysis showed that nebivolol was more effective than
atenolol on E/A wave ratio normalization. Compared with atenolol treatment,
nebivolol had a greater protective effect on different TOD markers, inducing a
decrease in collagen deposition and a reduction in the proinflammatory cytokines
IL-6 and TNF-α in the left ventricle and aorta. Our findings suggest that the
adverse hemodynamic profile and the reduced cardiovascular protection reported
with traditional β-blockers must not be carried forward to third-generation
β-blocker" - Note: For years cardiologists have put out that
third-generation Nebivolol wouldn't work for heart failure and you had to use
the first generation ones with unbearable side effects. That said, with Entresto
and Jaridience or Farxiga, why do you even need a beta-blocker?
-
Beta
blockers can repair malformed blood vessels in the brain - Science Daily,
2/23/21
-
Comparison of Outcomes of
Beta-Blocker Therapy after Acute Myocardial Infarction in Patients without Heart
Failure or Left Ventricular Systolic Dysfunction (From the Acute Coronary
Syndromes Israeli Survey [ACSIS]) - Am J Cardiol 2020 Dec 21 -
"The 30-day MACE [Major Adverse Cardiovascular (CV)
Events] rates were similar in patients on vs. not on beta-blockers at discharge
(9.0% and 9.5%, respectively). One year survival did not differ significantly
between those on vs. not on beta-blockers (HR 0.8, 95% CI 0.58-1.11, P= 0.18).In
conclusion, beta-blocker therapy did not affect 30 days MACE or one-year
survival after myocardial infarction in patients without heart failure or
reduced ejection fraction"
-
Women taking beta blockers for hypertension may have higher risk of heart
failure with acute coronary syndrome - AHA, 7/13/20 -
"women had a 4.6% higher rate of heart failure than men
when presenting to the hospital with acute coronary syndrome"
-
Beta-blockers in
hypertension: overview and meta-analysis of randomized outcome trials - J
Hypertens 2020 Jul 6 - "Compared with other
antihypertensive agents, beta-blockers appear to be substantially less
protective against stroke and overall mortality. However, they exhibit a
substantial risk-reducing ability for all events when prescribed to lower BP in
patients with modest or more clear BP elevations, and therefore can be used as
additional agents in hypertensive patients"
-
Going Off Beta Blockers an
Option in Selected Low-Risk LQTS, Group Proposes - Medscape, 3/9/20 -
"Not everyone diagnosed with long-QT syndrome (LQTS)
needs to take beta blockers to cut their risk for sudden death, despite
guidelines that recommend all such patients be given the drugs ... Such patients
who are judged to be at exceptionally low risk from their LQTS and who want to
avoid the often oppressive side effects of
beta blockers can safely
follow an "intentional nontherapy" strategy ... Most of the nontreated patients
in the analysis had started on beta blockers, "hated it, then moved to
intentional nontherapy,"" - Note:
Nebivolol has the least side effects but it's also the most expensive.
Seems like doctors prescribe whatever's cheap but what's quality of life worth?
ReliableRx sells nebivolol.
-
Effects of
third-generation β-blockers, atenolol or amlodipine on blood pressure
variability and target organ damage in spontaneously hypertensive rats - J
Hypertens. 2020 Mar;38(3):536-545 - "β-blockers are no
longer considered as first-line antihypertensive drugs due to their lower
cardioprotection ... Considering the differences in the pharmacological
properties of β-blockers, the present work compared the effects of
third-generation β-blockers - carvedilol and nebivolol - with a first-line agent
- amlodipine - on hemodynamic parameters, including short-term blood pressure
variability (BPV), and their ability to prevent target organ damage in
spontaneously hypertensive rats (SHR). SHR rats were orally treated with
carvedilol, nebivolol, atenolol, amlodipine or vehicle for 8 weeks ...
Carvedilol, nebivolol or amlodipine induced a greater reduction of carotid BP,
short-term BPV and echocardiography parameters than atenolol in SHR rats.
Carvedilol, nebivolol and amlodipine were more effective than atenolol in the
prevention of cardiac hypertrophy, and cardiac and aortic collagen deposit.
Carvedilol and nebivolol, but not atenolol, reduced the expressions of fibrotic
and inflammatory biomarkers - TGF-β, TNF-�� and IL-6 - in SHR rats to a similar
extent to that of amlodipine ... Chronic treatment with carvedilol or nebivolol
attenuates carotid BP and short-term BPV, and reduces target organ damage in SHR
to a greater extent than atenolol. Our findings suggest that the lower
cardiovascular protection of nonvasodilating β-blockers, as atenolol, in
hypertension must not be translated to third-generation β-blockers" -
Note:
ReliableRx sells nebivolol.
-
Real-world efficacy and
safety of nebivolol in Korean patients with hypertension from the BENEFIT KOREA
study - J Hypertens. 2019 Nov 5 - "heart rate (HR)
... Nebivolol significantly decreased mean SBP and DBP at 12 and 24 weeks
compared with baseline (P < 0.0001). A significant reduction in HR was also
observed at 12 and 24 weeks (P < 0.0001). The reductions of SBP and DBP were
notably greater when nebivolol was used as monotherapy in de novo patients
(P < 0.0001) and as add-on therapy to existing antihypertensives (angiotensin II
receptor blockers, angiotensin-converting enzyme inhibitors and calcium channel
blockers; P < 0.0001). Majority of the reported adverse events were mild; the
most common adverse events were dizziness (1.3%), headache (1.0%) and dyspnea
(0.9%)" -
Note:
ReliableRx sells nebivolol.
-
Why beta-blockers cause skin inflammation - Science Daily,
11/7/19 - "in some patients they can
trigger or exacerbate psoriasis, an inflammatory skin disease
... Its fat solubility enables the active substance to cross
biomembranes -- thin, fat-like membranes that enclose cells and
some of their components. The second aspect however ensures that
propranolol becomes positively charged in an acidic environment.
In this state, the substance can no longer return through the
membrane"
-
Long-Term Beta Blockers
Post-CABG Questioned, Even With Low LVEF - Medscape, 9/12/19 -
"The analysis saw mortality go steadily down over about
8 years following CABG for patients who stayed on statins, antiplatelets, and
renin-angiotensin system (RAS) inhibitors, but beta blockers conferred no such
survival benefit ... Indeed, the study's "biggest surprise" was that beta
blockers didn't help survival even in a subgroup that might seem more likely to
benefit, those with poor left ventricular (LV) systolic function ... We had a
very crude characterization of left ventricular function"
-
Betablockers in hypertension : acquiring a balanced view - European Society
of Cardiology, 19 May 2010
-
Beta
blockers can block the effects of stress and anger in patients prone to
emotion-triggered atrial fibrillation - Science Daily, 6/4/19 -
"patients taking beta blockers experienced anger
and stress as often as those not taking these medications, however, these
emotional episodes increased the odds of AF by just four times compared with 20
times in those not taking beta blockers. In participants taking beta blockers
not including anti-arrhythmic properties the effect was even stronger,
completely blocking the pro-arrhythmic effect of anger or stress"
-
Common Drugs May Be Contributing to Depression - NYT, 6/13/18 -
"About 200 prescription drugs can cause depression, and
the list includes common medications like proton pump inhibitors (P.P.I.s) used
to treat acid reflux, beta-blockers used to treat high blood pressure, birth
control pills and emergency contraceptives, anticonvulsants like gabapentin,
corticosteroids like prednisone and even prescription-strength ibuprofen ... For
some drugs, like beta-blockers and interferon, the side effect of depression is
well known"
-
Beta-Blockers May Raise
Mortality in People With Diabetes - Medscape, 4/5/18 -
"Among those with diabetes, all-cause death event rates
per 1000 person-years were 40.6 for those taking beta-blockers versus 17.1 for
those not taking them. Among participants without diabetes, those rates were
13.8 and 5.9, respectively"
-
Blood pressure meds could raise your depression risk - CNN, 10/10/16 -
"people taking one of two classes of drugs, known beta
blockers or calcium channel antagonists, had twice the risk of being admitted
into the hospital with a mood disorder, such as severe depression. However,
people taking a class of drugs known as angiotensin blockers -- ACE inhibitors
-- had a lower risk of developing severe mood disorders, even compared with
healthy control groups with no history of hypertension or depression"
-
Antihypertensive drugs decrease risk of Alzheimer disease: Ginkgo Evaluation of
Memory Study - Neurology. 2013 Aug 2 - "Secondary
longitudinal data analysis of the Ginkgo Evaluation of Memory Study in older
adults at least 75 years of age with normal cognition (n = 1,928) or MCI (n =
320) over a median 6.1-year period ... Hazard ratio for incident AD dementia
among participants with normal cognition was 0.51 in diuretic (95% confidence
interval [CI] 0.31-0.82), 0.31 in ARB (95% CI 0.14-0.68), 0.50 in ACE-I (95% CI
0.29-0.83), 0.62 in CCB (95% CI 0.35-1.09), and 0.58 in BB (95% CI 0.36-0.93)
users and was not significantly altered when mean systolic blood pressure was
above 140 mm Hg" - Note: Sounds like the ARB's left the others in the
dust. See my telmisartan as a first line
treatment page.
-
Can
blood pressure drugs reduce the risk of dementia? - Science Daily, 1/7/13 -
"The study found that all types of blood pressure
treatments were clearly better than no treatment. However, men who had received
beta blockers as their only blood pressure medication had fewer abnormalities in
their brains compared to those who had not been treated for their hypertension,
or who had received other blood pressure medications" - Yeah but what
about the side effects of beta blockers compared to other options:
-
Expert:
Time to break the beta blocker habit? - Science Daily, 11/12/12 -
"Studies show that older beta blockers can increase a
patient's risk of diabetes by more than 25 percent ... The newer classes of beta
blockers seem to reduce those risks" - Note: I've done a lot of reading
over the years and this is the first time I've see where there's a difference
between beta-blockers as far as the increased risk of diabetes. It would have
been helpful if the listed the new and old beta blockers they refer to.
-
Expert:
Time to break the beta blocker habit? - Science Daily, 11/12/12 -
"Studies show that older beta blockers can increase a
patient's risk of diabetes by more than 25 percent ... The newer classes of beta
blockers seem to reduce those risks" - Note: I've done a lot of reading
over the years and this is the first time I've see where there's a difference
between beta-blockers as far as the increased risk of diabetes. It would have
been helpful if the listed the new and old beta blockers they refer to.
-
Ivabradine Front-Page UK
News for Heart Failure - Medscape, 3/7/12
-
A
heart-rate-reducing medication reduces the risk of heart failure and cardiac
fibrosis - Science Daily, 7/28/11
-
Beta-Blocker
Use Is Associated With Improved Relapse-Free Survival in Patients With
Triple-Negative Breast Cancer - J Clin Oncol. 2011 May 31 -
"pathologic complete response (pCR) rates ...
relapse-free survival (RFS), and overall survival (OS) ... Patients who used BBs
(n = 102) were compared with patients (n = 1,311) who did not. Patients
receiving BBs tended to be older and obese (P < .001). The proportion of pCR was
not significantly different between the groups (P = .48). After adjustment for
age, race, stage, grade, receptor status, lymphovascular invasion, body mass
index, diabetes, hypertension, and angiotensin-converting enzyme inhibitor use,
BB intake was associated with a significantly better RFS (hazard ratio [HR],
0.52; 95% CI, 0.31 to 0.88) but not OS (P = .09). Among patients with
triple-negative breast cancer (TNBC; n = 377), BB intake was associated with
improved RFS (HR, 0.30; 95% CI, 0.10 to 0.87; P = .027) but not OS (HR, 0.35;
95% CI, 0.12 to 1.00; P = .05). CONCLUSION In this study, BB intake was
associated with improved RFS in all patients with breast cancer and in patients
with TNBC"
-
Beta
Blockers and Breast Cancer Mortality: A Population-Based Study - J Clin
Oncol. 2011 May 31 - "Propranolol users were
significantly less likely to present with a T4 (odds ratio [OR], 0.24, 95% CI,
0.07 to 0.85) or N2/N3/M1 (OR, 0.20; 95% CI, 0.04 to 0.88) tumor compared with
matched nonusers. The cumulative probability of breast cancer-specific mortality
was significantly lower for propranolol users compared with matched nonusers
(hazard ratio, 0.19; 95% CI, 0.06 to 0.60). There was no difference in T4 or
N2/N3/M1 tumor incidence or breast cancer-specific mortality between atenolol
users and matched nonusers. CONCLUSION The results provide evidence in humans to
support preclinical observations suggesting that inhibiting the β(2)-adrenergic
signaling pathway can reduce breast cancer progression and mortality"
-
Stress
accelerates breast cancer progression in mice, researchers find - Science
Daily, 9/15/10 - "stress is biologically reprogramming
the immune cells that are trying to fight the cancer, transforming them instead
from soldiers protecting the body against disease into aiders and abettors. The
study found a 30-fold increase in cancer spread throughout the bodies of
stressed mice compared to those that were not stressed ... Beta blockers, used
in this study to shut down the stress pathways in the mice, are currently being
examined in several large breast cancer databases for their role in potential
prevention of recurrence and cancer spread ... using beta blockers in stressed
mice prevented the same cancer progression seen in the stressed mice that did
not receive medication"
-
Beta-Blocker May Erase Fearful Memories - WebMD, 2/16/09
-
Erectile
Dysfunction in Men With Congenital Heart Disease - Am J Cardiol. 2008 Dec
15;102(12):1728-1730 - "beta blockers ... Men on BB were
3.13 times more likely to report ED"
-
Heart
Rate-lowering Drug Improves Exercise Capacity In Patients With Stable Angina
- Science Daily, 11/4/08 - "adding ivabradine over and
above the standard of care achieves increases exercise tolerance"
-
2 Beta
Blockers Found To Also Protect Heart Tissue - Science Daily, 9/15/08
-
Impact of beta-blockers on sleep in patients with mild hypertension: a
randomized trial between nebivolol and metoprolol - Adv Ther. 2008 Aug 28 -
"Nebivolol was associated with improved sleep (as
assessed by the PSQI), whereas metoprolol was associated with a worsening of
sleep characteristics"
-
Hypertension Treatment Effective In Reversing Vascular Damage, Study Suggests
- Science Daily, 6/17/08 - "A hypertension medication
called olmesartan medoxomil is effective in reversing the narrowing of the
arteries that occurs in patients with high blood pressure ... After one year of
treatment, olmesartan medoxomil improved the artery abnormalities in high blood
pressure patients and returned arterial architecture to normal levels. This was
not seen with the atenolol" - Note: Olmesartan is an
ARB, the same class of drugs as is telmisartan which
has been my recommendation. Atenolol is a
beta-blocker. I was prescribed atenolol once. It took me an hour and forty
minutes to complete a swim that usually took an hour and twenty minutes. If
that weren't bad enough, I felt like I was going to pass out after the longer
time swim.
-
Beta-Blockers for Hypertension, Heart Failure Prevention May Raise Stroke Risk
- Doctor's Guide, 11/7/07 - "The apparent
anti-hypertensive efficacy of beta-blockers was comparable to other agents, and
resulted in no incremental benefit for reduction in heart failure risk for the
overall cohort ... However, the increased stroke risk may be related to the
pseudoantihypertensive effect of traditional beta-blockers -- failure to lower
central aortic pressure when compared to other antihypertensives"
-
Blood
Pressure Drug Curbs Brain Damage From Alzheimer's, Depression And Schizophrenia
- Science Daily, 11/6/07 - "Prazosin, also prescribed as
an antipsychotic medication, appears to block the increase of steroid hormones
known as glucocorticoids ... Scientists believe stress activates a neurochemical
response in the brain that triggers the release of glucocorticoids in the brain,
and that high levels of glucocorticoids in blood serum are associated with such
psychiatric conditions as schizophrenia, depression, PTSD and Alzheimer's
disease"
-
A Meta-Analysis of 94,492 Patients With Hypertension Treated With Beta Blockers
to Determine the Risk of New-Onset Diabetes Mellitus - Am J Cardiol. 2007
Oct 15;100(8):1254-1262 - "Beta-blocker therapy resulted
in a 22% increased risk for new-onset DM ... beta blockers resulted in a 15%
increased risk for stroke"
-
Doctors Urged to Curb Reliance on Beta Blockers - Intelihealth, 8/7/07 -
"The side effects are probably the worst ... While
beta-blockers reduce blood pressure, the other drugs do so more effectively and
with fewer complications"
-
Thiazide and Beta-Blocker
Use Linked With Increased Risk for Incident Diabetes - Medscape, 5/8/07 -
"the relative risk of incident diabetes for those taking a thiazide diuretic
compared with those not taking a thiazide was 1.20 (95% confidence interval
[CI], 1.08 - 1.33) in older women; 1.45 (95% CI, 1.17 - 1.79) in younger women;
and 1.36 (95% CI, 1.17 - 1.58) in men ... the risk for incident diabetes was
also increased in patients taking beta-blockers relative to those who were not:
1.32 (95% CI, 1.20 - 1.46) in older women and 1.20 (95% CI, 1.05 -1.38) in men.
In younger women, a category of "other antihypertensives" was used that included
beta-blockers, and their use was associated with an increased risk for 1.46"
-
Effect of losartan, compared with atenolol, on endothelial function and
oxidative stress in patients with type 2 diabetes and hypertension - J
Hypertens. 2007 Apr;25(4):785-791 -
"losartan significantly improved endothelial function in
type 2 diabetes patients with hypertension compared with atenolol. This must be
independent of the blood pressure-lowering effect of losartan and is probably
caused by an antioxidative effect of the angiotensin receptor blocker"
-
Cochrane on Beta Blockers
- Medscape, 2/2/07 -
"The available evidence does not support the use of beta
blockers as first-line drugs in the treatment of hypertension"
-
Beta
Blockers Are Less Effective Than Other Drugs For First-line Treatment Of High
Blood Pressure - Science Daily, 1/24/07 -
"they were not as good at reducing death or the severity
of disease as other classes of drugs. Drugs that perform better include
thiazides, calcium channel blockers and renin angiotensin system inhibitors ...
The beta blocker given to 75% of these participants was atenolol"
-
Angiotensin Receptor Blocker Added to Previous Antihypertensive Agents on
Arteries of Diabetic Hypertensive Patients - Hypertension. 2006 Jun 19 -
"After 1 year of treatment, resistance artery
media:lumen ratio decreased in the valsartan group (7.9+/-0.5% after versus
9.8+/-0.6% before; P<0.05) but not in the atenolol-treated group"
-
New advice on
blood-pressure drug - BBC, 6/27/06 - "A class of
drugs called beta-blockers should no longer be given to patients with high blood
pressure ... using beta-blockers can also increase the risk of diabetes"
-
Thiazide and Beta-Blocker
Use Linked With Increased Risk for Incident Diabetes - Medscape, 5/8/06 -
"The multivariate risk ratios of developing diabetes associated with taking
beta-blocker medications were 1.25 and 1.21 in the NHS I and HPFS, respectively"
-
Hypertension Drug May Restore Cardiovascular Function In African Americans -
Science Daily, 3/11/06
-
Hopkins
Study May Change Rules For Treating Heart Failure; Discovery Suggests That Some
Patients On Beta Blockers Should Not Be - Science Daily, 11/28/05 -
"During exercise, the heartbeat does not increase as
expected, which limits the capability of these patients to pump blood to the
body"
-
Beta-Blockers May Not Be Best for Blood Pressure - WebMD, 10/18/05
-
More doubt on blood
pressure drug - BBC News, 10/17/05 -
"the risk of stroke was 16% higher with beta blockers
than with other drugs ... When the team looked at atenolol separately, the risk
of stroke was 26% higher than for other drugs"
-
Strategies to Prevent Type 2 Diabetes - Medscape, 8/8/05 -
"Valsartan reduced the incidence of new-onset diabetes
by 23% ... Traditional beta-blockers worsen insulin sensitivity and increase the
risk of developing new diabetes ... Some of the most widely used
anti-hypertensives, particularly the traditional beta blockers such as
propranolol, timolol, metoprolol and atenolol, and diuretics such as
hydrochlorothiazide and chlorthalidone (in high doses), worsen insulin
resistance and increase the risk of developing type 2 diabetes"
- Beta blockers and surgery
not a good mix? - MSNBC, 7/27/05
-
New Study Reports Treatment with Toprol-XL (Metoprolol Succinate)
Extended-Release Tablets for Hypertensive Children - Doctor's Guide,
5/18/05
-
Blood Pressure
Linked to Erectile Dysfunction - WebMD, 5/16/05 -
"Men on older high blood pressure medications
(diuretics, beta-blockers) had higher rates and more severe erectile
dysfunction than men on newer medications (calcium antagonists, ACE
inhibitors, angiotensin II receptor blockers)"
-
Three-Drug Combo May Best Protect Heart - HealthDay, 5/5/05 -
"The study of more than 13,000 patients diagnosed
with ischemic heart disease between 1996 and 2003 ... the combination of
statins, aspirin and beta-blockers resulted in an 83 percent reduction in
deaths among these patients"
-
The Effects of Losartan Compared to Atenolol on Stroke - Medscape,
4/14/05 - "these data suggest that losartan-based
treatment reduces CV complications, primarily stroke, when compared to
atenolol-based treatment for patients with ISH and high CV risk"
-
Beta-blockers May Help Broader Group Of Patients With Heart Problems -
Science Daily, 3/17/05
-
Study Faults Popular Hypertension Drug - HealthDay, 11/5/04
- Study:
Tenormin Not Best Blood Pressure Drug - WebMD, 11/4/04
- Beta-Blocker
Drugs Safely Treat Heart Failure - WebMD, 7/12/04
-
Telmisartan Associated with Greater Left Ventricular Hypertrophy Regression
Than Carvedilol - Doctor's Guide, 6/17/04 -
"The angiotensin II receptor blocker telmisartan
produces significantly greater left ventricular hypertrophy (LVH) regression
than does the beta blocker carvedilol in hypertensive patients"
-
Verapamil SR Has More Favorable Impact on Mood Than Atenolol in Hypertensive
Patients - Doctor's Guide, 5/25/04
-
Doxazosin Treatment for Hypertension Associated with Increased Risk of Heart
Failure in Diabetic Adults - Doctor's Guide, 4/12/04
-
Losartan-Based Treatment Appears More Effective In Reducing Strokes In
Hypertensives Than Atenolol-Based Treatment - Doctor's Guide, 4/1/04
-
Carvedilol May Top Metoprolol for Preventing Major Vascular Events in Heart
Failure Patients - Doctor's Guide, 3/11/04
-
Use of alpha-Blockers for Hypertension Declined After Publication of
Unfavorable Clinical Trial Results - Doctor's Guide, 1/6/04
-
Knowledge About Beta-Blocker Side Effects May Lead To Erectile Dysfunction
- Doctor's Guide, 11/18/03
-
Beta Blockade Reduces Heart Rate the Most in Sickest Heart Failure Patients
But Does Not Increase Overall Survival - Doctor's Guide, 11/10/03
-
Losartan Improves Cognitive Function in Elderly Hypertensive Patients -
Doctor's Guide, 10/31/03 -
"Patients receiving
losartan showed significant improvement in both
memory tests, while those receiving atenolol did not shown a difference with
treatment. Losartan treatment was associated with a 2.2 point increase in
word list memory score and a 2.1 point increase in the word list recall
score ... Notably, a greater number of adverse events were reported in
patients given atenolol than in those given losartan (31 vs. 8 events)"
- Heart Failure Drugs
May Target Both Beta-Adrenergic and Angiotensin II Receptors - Medscape,
9/8/03 -
"Beta-adrenergic receptors and
angiotensin II type 1 receptors join to form receptor complexes,
allowing single antagonist drugs used to treat heart failure to have a dual
effect ... It's like getting two drugs for the price of one ... Because
angiotensin blockers are better tolerated, they could be given alone to
patients too sick to take beta-blockers"
-
Two Blood Pressure Drugs May Act as One - HealthDay, 9/8/03 -
"The drugs are beta blockers, which act on receptors
that control the amount of blood delivered to the body at times of stress,
and angiotensin-converting enzyme (ACE)
inhibitors, which act on receptors that regulate growth of heart muscle
... There has been evidence that these two receptors act as a pair"
-
Effect of losartan on sudden cardiac death in people with diabetes: data
from the LIFE study - Lancet. 2003 Aug 23;362(9384):619-20 -
"In the losartan group,
five (6%) of 86 patients with diabetes and atrial fibrillation during the
trial died of sudden cardiac death compared with nine (2%) of 500 in those
without atrial fibrillation. The respective figures for the atenolol group
were 14 (13%) of 105 and 16 (3%) of 504. Our results suggest losartan
affords better protection against cardiac death from arrhythmias for
patients with diabetes mellitus than does atenolol"
-
Losartan Superior to Atenolol For Reducing Cardiac Death From Arrhythmias In
Hypertensive Diabetics - Doctor's Guide, 8/21/03
-
Losartan More Effective Than Atenolol in Preventing Morbidity and Mortality
in Low-Risk Hypertensive Patients - Doctor's Guide, 8/21/03 -
"Losartan appears to be
more effective than atenolol in preventing cardiovascular morbidity and
death - especially fatal and non-fatal stroke - in patients with
hypertension but without clinically evident vascular disease.
Furthermore, the effect appears to be independent of blood pressure
reduction ... In addition, incident diabetes occurred less often in patients
treated with losartan"
-
Losartan Causes Greater Regression of Left Ventricular Hypertrophy Compared
to Atenolol - Doctor's Guide, 8/8/03
-
Carvedilol Confers Significant Benefit In Survival Over Metoprolol in
Patients With Chronic Heart Failure - Doctor's Guide, 7/8/03
-
Heart Failure Patients Live Longer on Carvedilol than on Metoprolol -
Doctor's Guide, 7/4/03
-
A Better Beta Blocker For Heart Failure - HeathDay, 7/3/03
- Patients Live
Longer Taking Coreg Than Lopressor in First Head-to-Head Comparison -
WebMD, 7/3/03
-
Carvedilol Has Significant Mortality Benefit Over Metoprolol - Doctor's
Guide, 6/23/03
-
Beta-Blockers More Likely than Other Antihypertensives to Cause Orthostatic
Hypotension in Elderly - Doctor's Guide, 5/27/03
-
Periodic Limb Movements Increase with Isradipine, Decrease with Atenolol
- Doctor's Guide, 5/21/03
-
COMET Study Shows Carvedilol Saves Significantly More Lives than Metoprolol
- Doctor's Guide, 5/12/03
-
Bedtime Dosing Significantly Lowers Morning Blood Pressure In Hypertensives
- Doctor's Guide, 4/9/03
-
LIFE Sub-Study Finds Losartan Superior To Atenolol In Atrial Fibrillation
- Doctor's Guide, 4/4/03
-
No Differences Seen Between Calcium Channel Blocker and Beta Blocker in
INVEST Trial - Doctor's Guide, 4/3/03
-
Beta-Blockers Reduce Lipid Peroxidation, But Not Endothelial Damage, In
Chronic Heart Failure - Doctor's Guide, 4/2/03
-
Beta Blockers Reduce Mortality Among Myocardial Infarction Patients In
Valiant Trial - Doctor's Guide, 3/31/03
-
FDA Approves Coreg (Carvedilol) For Reducing Risk of Death Among Heart
Attack Patients With Impaired Cardiac Function - Doctor's Guide, 3/28/03
-
FDA Approves Once-A-Day InnoPran XL(Propranolol) For Hypertension -
Doctor's Guide, 3/13/03
-
Long-Term Beta-Blockade Improves Left Ventricular Ejection Fraction and
Prognosis in Chronic Heart Failure Patients - Doctor's Guide, 3/5/03
-
Statins/Beta Blockers Impact On Certain C-Reactive Protein Levels -
Doctor's Guide, 1/29/03 -
"Some 93% of the 89 patients who did not use
beta-blockers and were in the highest
CRP category and had
exercise-induced
ischaemia,
compared with 42% among patients in the lower four categories. Similarly,
94% of the 67 patients who did not use
statins and were in the highest CRP
category had exercise-induced ischaemia, compared with 44% in the lower four
categories"
- Blood Pressure
Control -- Timing Matters - WebMD, 1/24/03 -
"Researchers found that the
diuretic and
calcium-channel blocker were
effective around the clock. The beta-blocker was the least effective of the
four drugs overall and it had no effect on blood pressure during the night
or in the early morning hours. ACE
inhibitors actually worked best while the study participants were
sleeping, but had little effect on blood pressure during the day"
-
Elderly Heart-failure Patients Benefit from Beta-blocker Treatment -
Doctor's Guide, 1/24/03
-
Asthmatics With Congestive Heart Failure Do Not Tolerate Carvedilol -
Doctor's Guide, 1/13/03
-
FDA Advisory Committee Recommends Use Of Coreg (Carvedilol) For Heart Attack
Patients With Impaired Cardiac Function - Doctor's Guide, 1/8/03
- BP Drug Cozaar
Also Prevents Stroke - WebMD, 1/7/03 - "Cozaar
reduced the risk of stroke by about 25%
compared with atenolol"
-
Carvedilol Reduces Inappropriate Increase in Ventilation During Exercise in
Heart Failure Patients - Doctor's Guide, 1/2/03
-
Elderly Risk Airways Obstruction From Beta Blockers For Glaucoma -
Doctor's Guide, 12/13/02
-
Differing Effects Of Antihypertensive Drugs On Arterial Pulse Wave And
Natriuretic Peptide Secretion - Doctor's Guide, 12/3/02 -
"The greatest drop in blood pressure occurred with
bisoprolol. Paradoxically, bisoprolol also increased augmentation index with
a related three-fold increase in plasma brain natriuretic peptide"
-
Carvedilol Decreases Oxidative Stress and Lowers Serum C-reactive Protein in
Patients With Essential Hypertension - Doctor's Guide, 10/1/02
-
Chronic Therapy with Beta-Adrenergic Receptor Blockers Improves Endothelial
Function in Patients with Chronic Heart Failure - Doctor's Guide,
9/30/02 -
"Plasma
norepinephrine levels decreased from 591 pg/mL before treatment to 426
pg/mL after six months of beta-blockade"
-
Losartan Superior in Isolated Systolic Hypertension with Left Ventricular
Hypertrophy - Doctor's Guide, 9/25/02
- Losartan Better Than
Atenolol at Reducing Cardiovascular Risk - Medscape, 9/25/02
-
Differential Effects of Beta-Blocker Therapy on Ventilatory Efficiency and
Exercise Capacity in Patients with Systolic Heart Failure - Doctor's
Guide, 9/24/02
-
Variation in Use of Beta Blockers Among Specialists, Primary Care Physicians
Cited - Doctor's Guide, 9/24/02
-
Mechanistic Differences Between Carvedilol and Metoprolol Cited -
Doctor's Guide, 9/24/02
-
LIFE Substudy Shows Losartan Superior to Atenolol at Reducing Stroke Risk
- Doctor's Guide, 9/16/02
-
Beta Blockers May Attenuate Mortality in Black Patients Taking Certain
Calcium Channel Blockers - Doctor's Guide, 9/13/02
-
Losartan Superior To Atenolol In Reducing Left Ventricular Hypertrophy In
Hypertensives - Doctor's Guide, 9/4/02
-
Patient Compliance with Antihypertensive Therapy Appears Longer for Those
Taking Angiotensin II Antagonists - Doctor's Guide, 7/18/02 -
"The researchers found that the class of drug had a statistically
significant effect on the patients' persistence of compliance. Angiotensin
II antagonists had the highest rate of persistence followed by ACE
inhibitors, calcium channel blockers, beta-blockers, and diuretics"
-
Beta-Blockers Not Associated With Depression, Fatigue, Sexual Dysfunction
- Doctor's Guide, 7/17/02
-
Cozaar (Losartan) Lowered Risk Of Total Mortality In Patients With Diabetes
By 39% Versus Atenolol - Doctor's Guide, 6/27/02 -
"treatment with
losartan resulted in a 24 per cent reduction in the primary composite
endpoint of cardiovascular death, stroke
and heart attack compared to
the beta-blocker atenolol (p=0.03). Blood
pressure and pulse pressure reductions were similar with both therapies.
In addition, losartan significantly reduced the risk of cardiovascular death
by 37 per cent (p=0.03) and total mortality by 39 per cent ... A 39 per cent
reduction in total mortality with losartan is an important observation given
that the observed reduction is versus an established antihypertensive,
atenolol ... It is widely accepted that elevated systolic blood pressure is
an even stronger risk factor for cardiovascular events than diastolic blood
pressure"
- Antihypertensive
persistence and drug class - Can J Cardiol. 2002 Jun;18(6):649-56 -
"Angiotensin II antagonists had the highest
persistence followed by angiotensin-converting enzyme inhibitors, calcium
channel blockers, beta-blockers and diuretics"
-
Irbesartan More Effective than Atenolol in Reducing Cardiac Electrical
Instability - Doctor's Guide, 5/20/02
-
ß-Blockers Can Benefit Elderly People with Mild Hypertension - Doctor's
Guide, 4/15/02
-
Diabetic Hypertensives Benefit More From Losartan Than Atenolol -
Doctor's Guide, 3/22/02
-
Beta Blockers Lower Risk, Save Money in Surgeries - Doctor's Guide,
3/21/02
-
LIFE Study Finds Losartan More Effective than Atenolol in Hypertensive
Patients - Doctor's Guide, 3/20/02
-
Coreg (Carvedilol) Has Beneficial Effect In Women with Heart Failure -
Doctor's Guide, 3/19/02
-
Carvedilol Exhibits Beneficial Effects On Heart Failure Patients With Or
Without Digitalis - Doctor's Guide, 3/19/02
-
Chronic Heart Failure Patients Respond Differently To Beta Blockers
Carvedilol And Metoprolol - Doctor's Guide, 3/19/02
- Heart Failure
Drugs as Good for Women as for Men - WebMD, 3/12/02
-
In Heart Failure, Beta-Blockers Boost Survival Advantage For Women -
Doctor's Guide, 3/11/02
-
Beta-Blockade Adds Value For Hypercholesterolemics On Statins - Doctor's
Guide, 2/15/02
- Aspirin Plus Beta-Blocker
Reduce Risk of Post-Myocardial Infarction Deaths in Patients with End-stage
Renal Disease - Doctor's Guide, 11/12/01
- Beta-blocker, Carvedilol,
Shows Efficacy In African Americans - Doctor's Guide, 7/9/01
- Beta Blockers Don't Alter
QT Parameters in Children With Long QT Syndrome - Doctor's Guide, 6/1/01
- Better Compliance Found
With Once Daily Irbesartan Over Atenolol in Treatment of Pediatric Severe
Hypertension - Doctor's Guide, 5/30/01
- Even the Sickest
Patients Benefit From Beta-Blockers - WebMD, 5/30/01 - "an old-line
blood pressure drug can cut death rates by 35% in patients with very severe
congestive heart failure"
- Opinion: The Time
Has Come to Emphasize Beta-Blockers for Heart Failure, In Many Patients,
They Can Actually Help Heal the Heart - WebMD, 5/30/01 -
"probably the most surprising and most useful
advance for heart failure in the past several years is a pill that has been
around for decades -- the beta-blocker"
- Help for Failing
Hearts, Despite Its Name, Heart Failure Is Treatable - WebMD, 5/17/01 -
"This drug cocktail includes Digoxin to increase the
heart's pumping action; diuretics, or water pills, to help the body
eliminate excess salt and water; ACE inhibitors to expand blood vessels,
allow blood to flow more easily, and make the heart work more efficiently;
and beta-blockers to improve the function of the heart's left ventricle.
Beta-blockers also block a natural stress hormone capable of damaging the
heart. Blocking this hormone gives the heart a chance to recover and helps
prevent continued injury ... Though 80% of people with heart failure should
be taking beta-blockers, Packer says that only 15-20% are currently taking
them"
- African-Americans With
Heart Failure Derive Equal Benefit From Beta-Blockers As Do Caucasians -
Doctor's Guide, 4/30/01
- Blood Pressure
Drug May Ease Severe Cocaine Withdrawal, Can Serve as a Bridge From
Addiction to Sobriety - WebMD, 4/12/01 -
"the drug, known as Inderal, seems to work best in
those patients experiencing very severe withdrawal symptoms"
- Beta-Blocker Metoprolol
Slows Wall Thickening Of Carotid Artery In Healthy People - Doctor's
Guide, 4/3/01
- Beta-Blockers
Showing Usefulness in Preventing Disease - WebMD, 4/2/01 -
"now appears to slow artery clogging atherosclerosis
as well, and thus may be useful to prevent strokes and heart disease
altogether ... Metoprolol slowed the progression of atherosclerosis by about
40%. The participants taking metoprolol also tended to have fewer strokes
and heart attacks during this time ... the group taking fluvastatin had a
75% reduction in progression of carotid artery wall thickening. As
fluvastatin and metoprolol seemed to work at different sites along the
carotid artery, they might be used together for greater effect to prevent
heart disease and strokes"
-
Common blood pressure drug increases the risk of diabetes - CNN, 3/29/00
-
"A drug [beta-blockers] commonly used to treat high
blood pressure increases the risk of developing diabetes by 28 percent"
- Carvedilol Reduces Risk Of
Recurrent Heart Attack - Doctor's Guide, 3/21/01
- Are Putters Using
Blood Pressure Drugs to Shoot Better? - WebMD, 2/23/01 -
"beta-blockers may be giving some golfers an unfair
advantage by calming their nerves as they get set to swing. Beta-blockers
reduce the heart rate and the heart's output of blood. These drugs also may
reduce the anxiety"
- FDA Approves
Extended-Release Toprol-XL (Metoprolol Succinate) For Treatment Of Heart
Failure - Doctor's Guide, 2/7/01
-
Carvedilol Reduces But Valsartan May Increase Sexual Activity In
Hypertensive Men - Doctor's Guide, 2/1/01 -
"carvedilol induces a chronic reduction of sexual
activity whereas valsartan, an angiotensin II antagonist, not only does not
significantly reduce sexual activity but may even increase it."
- Angiotensin-converting
Enzyme Inhibitors, Beta Blockers May Postpone Kidney Failure - Doctor's
Guide, 10/13/00
-
Common blood pressure drug increases the risk of diabetes - CNN, 3/29/00
-
"A drug [beta-blockers] commonly used to treat high
blood pressure increases the risk of developing diabetes by 28 percent"
- Blood Pressure
Drug [Toprol XL] Saves Lives for Heart Failure Patients, It Also Brings
Shorter Hospital Stays and Better Quality of Life - WebMD, 3/7/00
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