Wednesday, June 28, 2006

Beta Blockers Leave Hypertension's Short List

Have high blood pressure and take beta blockers (like atenolol (Tenormin), metoprolol (Lopressor), carvedilol (Coreg))? In England, beta-blockers are no longer being recommended at mainstays of hypertension management in favor of calcium channel blockers (like diltiazem (Cardizem) or nifedipine (Procardia). And there is considerable data to support this finding. When it comes to beta blockers, hypertension management isn't the best: diuretics, ACE-inhibitors, and calcium channel blockers are probably better.

But as a doctor dealing on a day-to-day with cardiac rhythm disturbances, beta blockers are undeniably one of the most effective weapons we have at treating fast heart rhythms and heart failure and have been shown to reduce death in people with coronary artery disease. And in people with weak heart muscles, at least one calcium channel blocker (verapamil) has been shown to have deliterious effects on heart muscle function.

If you have hypertension that is difficult to manage, be sure to check with your doctor before considering a switch to an alternate medication, since often your doctor may be trying to to manage "two birds" (hypertension and arrhythmias or heart failure) with "one stone" (beta blockers).


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