Wednesday, January 25, 2023

How Do Beta Blockers Prevent Heart Attacks

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Are They Safe For Pregnant Women Kids And Older People

MedTap: Why you need to take beta-blockers after a heart attack

Calcium channel blockers can be used during pregnancy to manage high blood pressure and preeclampsia. However, you should always consult with your doctor before taking calcium channel blockers during pregnancy.

These drugs may pass into breast milk, but no adverse effect on breastfed infants has been found. Discuss the risks and benefits of using calcium channel blockers while breastfeeding with your doctor.

The safety of calcium channel blockers in children has not been established however, no problems have been found to date. Discuss the risks and benefits of giving your child calcium channel blockers with your childs doctor.

Older adults have more side effects from calcium channel blockers than younger people. Doctors usually prescribe lower doses.

Lower High Blood Pressure

Its a major risk factor for stroke a leading cause of disability in the United States. Stroke recovery is difficult at best and you could be disabled for life. Shake that salt habit, take your medications as recommended by your doctor and get moving. Those numbers need to get down and stay down. An optimal blood pressure reading is less than 120/80 mmHg.

Visit High Blood Pressure.

Side Effects Of Beta Blockers

Most people taking beta blockers have either no or very mild side effects that become less troublesome with time.

Contact your GP if you’re having symptoms that bother you or last more than a few days.

Side effects commonly reported by people taking beta blockers include:

  • feeling tired, dizzy or lightheaded
  • cold fingers or toes
  • difficulties sleeping or nightmares

It happens rarely, but some people have serious side effects when taking beta blockers.

Tell a doctor straight away if you have:

  • shortness of breath with a cough that gets worse when you exercise , swollen ankles or legs, chest pain, or an irregular heartbeat these are signs of heart problems
  • shortness of breath, wheezing and tightening of your chest these can be signs of lung problems
  • yellow skin or the whites of your eyes turn yellow these can be signs of liver problems

These are not all the side effects of beta blockers. For a full list, see the leaflet inside your medicine packet.

You can report suspected side effects using the Yellow Card Scheme.

For more information on the side effects of beta blockers, read about the specific medicine you take in our Medicines A to Z.

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Can I Take A Beta Blocker If I Have Diabetes

Yes, you can take a beta blocker if you have diabetes. But a beta blocker may hide some of the warning signs of low blood sugar. For example, when you take a beta blocker, your heart rate may not increase in response to a low blood sugar level. You will need to check your blood sugar levels carefully after you start taking a beta blocker. If you have low blood sugar often, your doctor may want to change the dosages of your diabetes medicines.

Who Needs A Beta Blocker

Early Use of Beta Blockers Can Save Life After Heart Attack

Beta blockers are used for many reasons, including:

  • angina

  • cardiac healing after a heart attack

  • heart failure

  • heart rhythm problems such as atrial fibrillation or palpitations

  • high blood pressure

  • hypertrophic cardiomyopathy

  • noncardiovascular conditions such as anxiety, essential tremor, glaucoma, migraine, and others.

Once a mainstay for treating high blood pressure, beta blockers have been elbowed aside by newer drugs, such as ACE inhibitors, and older ones, such as thiazide diuretics.

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What Were The Basic Results

Of the 179,810 people who survived a heart attack during this period, 9,373 died within a year of their initial hospitalisation.

94.8% of all survivors received beta-blockers when they were discharged from hospital. People who received beta blockers were more likely to be male , slightly younger , and less likely to have other medical illnesses like diabetes, kidney failure, history of stroke or asthma .

Looking at the raw numbers, after one year, fewer people had died among those who were prescribed beta-blockers than among those who didn’t take the drugs . However, with adjustment for confounding factors there was no significant link between beta-blockers and survival at one month, six months or one year.

There was no difference in effect depending on whether or not people had a heart attack with the classical heart attack features on electrocardiogram .

Soluble Guanylate Cyclase Stimulators

Soluble Guanylate Cyclase stimulatorshelp dialate blood vessels. The drug vericiguat can be prescribed for patients with chronic heart failure who have been hospitalized or need IV diuretics.

Vericiguat may help you live longer and lower your chance of having to go to the hospital for heart failure. It works by relaxing and widening the blood vessels so blood can flow more easily, which makes it easier for your heart to pump blood to your body.It helps reduce the risk of dying and further hospitalization.

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How Beta Blockers Work

Youve heard of the bodys fight-or-flight response? says Dr. Bietry. That response gets switched on when your body is under some form of stress. Beta adrenergic receptors that exist in a lot of different tissue, including cardiac tissue, are activated. Adrenaline is released. When that happens over and over, your heart gets damaged, he says, even changing in size and shape. Beta blockers prevent the hormones released during the stress response from causing additional damage to your heart.

There are more than a dozen beta blockers that treat a number of conditions, but essentially they all work in a similar fashion: They slow down heart rate and allow the heart to beat with less force by blocking the effects of adrenaline and other neurohormones. They also work to open up blood vessels, improving blood flow. Because there are multiple beta adrenergic receptors found in the heart, lungs, other organs, and in the smooth muscle that lines blood vessels, doctors select beta blockers according to which adrenergic receptor a particular drug interrupts.

Thats why, for example, a patient with chronic stable angina or another who recently had a heart attack might be prescribed carvedilol, while another patient who is experiencing frequent migraines might be put on propranolol, and a glaucoma patient will be prescribed timolol drops. When selecting beta blockers doctors also consider the patients medical history and any other medications theyre currently taking.

Manage The Blood Pressure Levels:

How do beta blockers work?

This is also one of the best tips on how to prevent heart attack naturally that people should follow. Persistent high blood pressure can put your heart and your arteries under extra strain, making the risks of heart attacks increased unintentionally.

People can reduce the risk of high blood pressure levels by moderating the daily consumption of alcohol, following a healthy diet, doing exercise regularly, and maintaining healthy weight.

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Selective Vs Nonselective Beta Blockers

There are two main types of beta blocker medications: selective beta blockers and nonselective beta blockers.

Selective beta blockers are designed specifically to block the 1 receptors, which are primarily located in the heart. Because the action of these beta blockers is more specific, theyre usually safe for use if you have diabetes.

Common selective beta blockers include acebutolol, atenolol, bisoprolol, betaxolol, bevantolol, celiprolol, metoprolol, esmolol and nebivolol.

Because selective beta blockers only affect the 1 receptors, which are concentrated in heart tissue, they tend to be used to treat heart conditions and arent a popular treatment option for anxiety.

Nonselective beta blockers are designed to block the 1, 2 and 3 receptors. This means that as well as targeting beta receptors in the heart, they also affect the veins, liver, pancreas and a range of other parts of the body.

Common nonselective beta blockers include alprenolol, carteolol, oxprenolol, propranolol and sotalol. As well as being used to treat certain heart conditions, nonselective beta blockers can be used to treat some physical effects of anxiety.

Unlike selective beta blockers, nonselective beta blockers are not considered safe to use if you have diabetes.

Medicines To Prevent Heart Attacks

Depending on your medical history, your doctor may also recommend certain medicines to reduce your heart attack risk.

Commonly prescribed drugs include:

Antiplatelet Drugs These drugs can also help prevent clots by preventing platelets in your blood from sticking together.

AspirinAspirin is the most widely used antiplatelet drug.

Angiotensen-Converting Enzyme Inhibitors ACE inhibitors lower blood pressure by expanding your blood vessels, which makes your hearts work easier.

Beta-BlockersBeta-blockers slow your heart rate, lowering your blood pressure and reducing strain on your heart.

Calcium Channel Blockers Calcium channel blockers block the movement of calcium into your heart and blood vessels, which helps them relax and lowers blood pressure.

Diuretics Also known as water pills, diuretics lower your blood pressure by removing excess fluids and sodium from your body in your urine.

StatinsStatins help to lower levels of LDL cholesterol and triglycerides in your blood, which may reduce your risk of atherosclerosis .

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What If I Forget To Take It

If you forget to take a dose of your beta blocker, take it as soon as you remember, unless it is nearly time for your next dose. In this case, just leave out the missed dose and take your next dose as normal.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

Interactions With Other Medicines

Beta blockers

Beta-blockers, including beta-blocker eye drops, can interact with other medicines, altering the effects of one of the medicines.

Read the patient information leaflet that comes with your medicine to check that it’s safe to take with beta-blockers. If you’re still unsure, you could also ask your GP or pharmacist.

Some of the more common medicines that can interact with beta-blockers include:

  • anti-arrhythmics used to control irregular heartbeats
  • antihypertensives used to lower blood pressure
  • antipsychotics used to treat severe mental health problems
  • clonidine used to treat high blood pressure and migraine
  • mefloquine used to treat or prevent malaria

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Can I Take A Beta Blocker If I Have Asthma Or Chronic Lung Disease

Beta blockers are generally not used in people with asthma. A beta blocker can cause asthma attacks.

Sometimes people with a chronic lung disease such as emphysema or bronchitis can take beta blockers. If you have lung disease and are taking a beta blocker, call your doctor right away if you start having breathing problems.

What Drugs Interact With Beta Blockers And Calcium Channel Blockers

Beta Blockers

  • Combining propranolol or pindolol with thioridazine or chlorpromazine may result in low blood pressure and abnormal heart rhythms because the drugs interfere with each others elimination and result in increased levels of the drugs.
  • Dangerous elevations in blood pressure may occur when clonidine is combined with a beta blocker, or when clonidine or beta blocker is discontinued after their concurrent use. Blood pressure should be closely monitored after initiation or discontinuation of clonidine or a beta blocker when they have been used together.
  • Phenobarbital and similar agents may increase the breakdown and reduce blood levels of propanolol or metoprolol . This may reduce effectiveness of the beta blocker.
  • Aspirin and other nonsteroidal anti-inflammatory drugs may counteract the blood pressure reducing effects of beta blockers by reducing the effects of prostaglandins, which play a role in control of blood pressure.
  • Beta blockers may prolong hypoglycemia and mask symptoms of hypoglycemia in diabetics who are taking insulin or other diabetic medications.

Calcium Channel Blockers

Grapefruit juice may elevate blood concentrations of felodipine , verapamil , nisoldipine , nifedipine , nicardipine , and possibly amlodipine . Grapefruit juice should not be consumed within 2 hours before or 4 hours after administration of affected calcium channel blockers.

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What Is Still Controversial

  • Are non-atenolol blockers superior to atenolol in preventing adverse cardiovascular outcomes in hypertensive patients?

  • Are blockers equivalent to other classes of antihypertensive agents in reducing clinical events in younger patients?

  • Can blockers reduce clinical events and improve prognosis in patients with coronary disease?

  • Will perioperative use of blockers reduce postoperative cardiovascular morbidity and mortality?

Cardiovascular Diseases: Avoiding Heart Attacks And Strokes

Why Can the Same Drug Treat Heart Attacks and Anxiety?

WHO estimates that more than 17.5 million people died of cardiovascular diseases such as heart attack or stroke in 2012. Contrary to popular belief, more than 3 out of 4 of these deaths occurred in low- and middle-income countries, and men and women were equally affected.

The good news, however, is that 80% of premature heart attacks and strokes are preventable. Healthy diet, regular physical activity, and not using tobacco products are the keys to prevention. Checking and controlling risk factors for heart disease and stroke such as high blood pressure, high cholesterol and high blood sugar or diabetes is also very important.

Eat a healthy diet: A balanced diet is crucial to a healthy heart and circulation system. This should include plenty of fruit and vegetables, whole grains, lean meat, fish and pulses with restricted salt, sugar and fat intake. Alcohol should also be used in moderation.

Take regular physical activity: At least 30 minutes of regular physical activity every day helps to maintain cardiovascular fitness at least 60 minutes on most days of the week helps to maintain healthy weight.

Avoid tobacco use: Tobacco in every form is very harmful to health cigarettes, cigars, pipes, or chewable tobacco. Exposure to second-hand tobacco smoke is also dangerous. The risk of heart attack and stroke starts to drop immediately after a person stops using tobacco products, and can drop by as much as half after 1 year.

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Is Treatment Outcome Affected By Type Of Blocker Used Or Age Profile Of Patient

blockers do not all produce the same outcome when used in the same clinical condition. A study similar to COPERNICUS but using bucindolol produced results different from those with carvedilol. In 2708 patients after two years, total mortality was not significantly affected by bucindolol . Although many reasons were postulated, the practical message is that some, but not all, blockers reduce mortality in heart failure.w9 Thus, in treating heart failure, clinicians should choose only those blockers that have been shown to be useful. Similarly, in hypertension, myocardial ischaemia, or after myocardial infarction, only those blockers with good evidence favouring their value should be used.

Older people with hypertension may have a different profile from younger ones. Khan and McAlister reviewed cardiovascular events in 145811 patients from 21 hypertension trials . Among patients under 60 years, blockers reduced cardiovascular outcomes compared with placebo and were equivalent to other antihypertensive drugs . In patients aged 60 and over, blockers were equivalent to placebo and were less effective in reducing cardiovascular outcomes than other antihypertensive drugs . These results are clinically reasonable, since the pathophysiology of hypertension is different in younger and older patients.

The No 1 Reason People Stop Taking Beta

The top reason patients stop using beta-blockers is admission to the hospital for various conditions, not just heart failure, Dr. Tang says. However, most people should not stop, even if they are hospitalized, unless the doctors decided that it is more harm than good.

Research shows that patients fare better when they continue taking beta-blockers while in the hospital, even with acute heart failure.

An inability to tolerate beta-blockers indicates a worsening heart condition, says Dr. Tang. Other testing may be necessary to determine if the heart is too weak for beta-blockers.

This may even apply for patients whose heart function has recovered to the normal range. Recent clinical studies have shown that, even in those with full recovery of their heart structure and function, stopping drugs like beta-blockers can reverse the recovery course and can be detrimental, he adds.

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How Other Factors Affect Heart Rate

  • Air temperature: When temperatures soar, the heart pumps a little more blood, so your pulse rate may increase, but usually no more than five to 10 beats a minute.
  • Body position: Resting, sitting or standing, your pulse is usually the same. Sometimes as you stand for the first 15 to 20 seconds, your pulse may go up a little bit, but after a couple of minutes it should settle down.
  • Emotions: If youre stressed, anxious or extraordinarily happy or sad your emotions can raise your pulse.
  • Body size: Body size usually doesnt change pulse. If youre very obese, you might see a higher resting pulse than normal, but usually not more than 100.
  • Medication use: Meds that block your adrenaline tend to slow your pulse, while too much thyroid medication or too high of a dosage will raise it.

Cautions With Other Medicines

Beta Blockers Treatment For Cardiovascular Disease Where ...

There are some medicines that may interfere with the way that beta blockers, including beta blocker eyedrops, work.

Tell your doctor if you’re taking:

  • other medicines for high blood pressure. The combination with beta blockers can sometimes lower your blood pressure too much. This may make you feel dizzy or faint
  • other medicines for an irregular heartbeat such as amiodarone or flecainide
  • other medicines that can lower your blood pressure. These include some antidepressants, nitrates , baclofen , medicines for an enlarged prostate gland like tamsulosin, or Parkinson’s disease medicines such as levodopa
  • medicines for asthma or chronic obstructive pulmonary disease
  • medicines for diabetes, particularly insulin beta blockers may make it more difficult to recognise the warning signs of low blood sugar
  • medicines to treat nose or sinus congestion, or other cold remedies
  • medicines for allergies, such as ephedrine, noradrenaline or adrenaline
  • non-steroidal anti-inflammatory medicines , such as ibuprofen. These medicines may increase your blood pressure, so it’s best to keep them to a minimum

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