Are beta blockers past their sell-by date?

Beta blockers may be less effective than other blood pressure lowering medicines at preventing illness and death, new research suggests.

High blood pressure increases the risk of heart attacks, strokes and other serious problems and there are a number of different drugs that can help to control the condition.

The latest NHS guidelines state that instead of beta blockers, most patients should be offered angiotensin-converting enzyme (ACE) inhibitors or, if these cause side effects, angiotensin II receptor blockers (ARBs). Both work by relaxing blood vessels.

Other options include calcium channel blockers and diuretics, often called ‘water pills’.

Beta blockers were one of the most commonly prescribed blood-pressure drugs in past decades, but they fell out of favour as newer tablets which appeared to be better at reducing blood pressure became available.

GPs have traditionally prescribed patients with high blood pressure with beta blockers, but experts say there are now more effective treatments available that reduce blood pressure

GPs say that some patients are reluctant to move across to the newer types of treatment

Despite this, GPs and cardiologists report that patients on beta blockers are often reluctant to switch.

The new study is one of the first to look at long-term health outcomes in patients taking all types of blood-pressure drugs.

German scientists analysed the case notes, held by UK Clinical Practice Research Datalink, from more than 380,000 patients.

They discovered that those on beta blockers were significantly likelier to die from a heart-related illness, and from any other cause, than those who had been prescribed ACE inhibitors.

High blood pressure, also known as hypertension, affects a third of British adults – although, because the condition rarely has noticeable symptoms, many do not realise it. The only way to find out if your blood pressure is high is to have it checked.

King’s College London cardiologist Professor Martin Cowie said: ‘Beta blockers have not been a first-line hypertension treatment for some time now, and newly diagnosed patients wouldn’t be put on them. But there are a lot of patients who have been on them for years, and are reluctant to change because they feel they’re working just fine.

‘The results of this study confirm what doctors have known for some time, and show that it might be a good idea for patients to be open-minded when speaking to their GP, and consider taking a different medicine going forward.’