Drugs: Beta-blockers constitute one of the major therapeutic classes in cardiology. ” There are a large number of different molecules, around ten are marketed in France,” explains Dr. Bensaïd. “They are useful in all areas of cardiology, but must be closely monitored by the cardiologist to be prescribed at the right dose and for the right indication.“, he adds.
Beta blockers: how do they work?
Beta-blockers block beta-adrenergic receptors. They have two types of activity: a direct activity on the heart, cardio-selective, and another activity, in particular peripheral. ” They are cardio-protective because they reduce the oxygen needs of the heart muscle, by acting on the heart rate and reducing the contractile force of the heart muscle. In the case of heart failure, they therefore have a protective role“, details the cardiologist.
These drugs also have a peripheral action. “They decrease adrenergic reactions, tremors, stress, sweating and emotion-induced tachycardia. They are then, for example, indicated in the treatment of hyperthyroidism (peripheral condition),” explains Dr. Bensaïd.
Beta-blockers: what are the indications?
Beta-blockers are indicated in the event of coronary diseases, following a myocardial infarction or in heart failure. They are also prescribed to treat arrhythmias.
« If the place of beta-blockers is increasingly minor in the treatment of arterial hypertension, they can still be used in patients who have hypertension resistant to other therapeutic classes or who have other cardiac pathologies with an indication for beta-blocker therapy“, adds Dr. Bensaïd.
On the other hand, it is absolutely necessary to avoid prescribing them in patients who are already taking drugs that slow down the heart, and to be cautious in patients who have respiratory problems. ” Avoid prescribing them to asthmatic patients, except with the express agreement of the cardiologist or pulmonologist.“, specifies the specialist.
Beta-blockers: how to use them and what are the side effects?
These drugs must be taken daily, in one or two doses per day, respecting a roughly fixed time interval between two doses. ” If you forget a dose, you should not double the dose!“, recalls the cardiologist. The latter also specifies that the treatment should never be stopped suddenly. If the dose must be reduced, it must be done in agreement with the doctor and always gradually.
Beta-blockers can cause undesirable effects if they are dosed too high or poorly adjusted to the real needs of the patient: fatigue, reduction in exercise capacity, sometimes a tendency to drowsiness, coldness of the hands and feet, sleep (insomnia, nightmares), erectile dysfunction in men. ” But they remain essential drugs, which have real indications, and which have demonstrated their effectiveness in what is called survival, in patients who have suffered a serious heart attack.“, concludes Dr. Bensaïd.
Thanks to Dr Alexandre Bensaid, cardiologist.
