Beta blockers • Effects, side effects, weight gain & withdrawal

Beta blockers are among the most commonly prescribed drugs. Because common diseases such as high blood pressure (hypertension), cardiac insufficiency (heart failure) and coronary heart disease are treated with it. Developed in the 1960s by the Scottish Nobel Prize winner Sir James Black, beta blockers were for a long time the only medicines that could slow the heart rate and lower blood pressure.

At a glance:

Effect of beta blockers: this is how the antihypertensive drugs work

Beta blocker is a short form, the drugs are called beta-receptor blockers or beta-adrenoceptor antagonists. Beta receptors are found on the cells of the blood vessels, heart, bronchi and kidneys, among other things. In general, receptors are docking points for messenger substances, for example hormones. This can be compared to the lock and key principle: the receptors are the keyhole and the hormones are the key. The key stress hormones adrenaline and noradrenaline fit into the beta receptors.

The body releases large amounts of these hormones under stress. They dock on the beta receptors. This activates the affected organs and typical stress reactions occur:

• The Blood vessels narrow,
• the heart beats faster,
• the Bronchi narrow and
• the Blood pressure increases.

These effects have been programmed in our cells since time immemorial and prepare the body for attack or flight. But the physical struggle through which the stress hormones would be broken down again does not take place in today's stressful situations. The activation persists – and this stress can damage the organs in the long term. High blood pressure develops, the heart and kidneys are weakened by the constant stress. Beta blockers can prevent these long-term effects by working in the following ways:

• They block the beta receptors
• the stress hormones can no longer dock.
• An overactivation of the organs is avoided in this way,
• The body does not react to stress.

What are the different beta blockers?

However, not all beta blockers are created equal. Because there are two different beta receptors (beta-1 and beta-2 receptors) on cells, additional beta blockers have been developed. Beta-1 receptors are mainly found in the heart, while beta-2 receptors are found outside the heart, such as the bronchi. There are therefore the following groups of beta blockers:

• Unselective Beta blockers: They block both beta-1 and beta-2 receptors. This group also included the first beta blockers.
• Selective Beta-1 receptors only block beta-1 receptors.
• Selective beta-2 receptors can only occupy beta-2 receptors.

The active ingredients of the most commonly prescribed beta blockers are:

• Atenolol
• Betaxolol
• Bisoprolol
• Carvedilol
• Celiprolol
• Metoprolol
• Nebivolol

Beta blockers used to be the first choice in drug therapy for high blood pressure. However, several studies have sparked discussions about the effects of these drugs. A meta-analysis of 20 studies showed that the beta blocker atenolol does not reduce the risk of stroke in high blood pressure patients as much as previously assumed.

What diseases are beta blockers used against?

However, it has been proven that the use of antihypertensive drugs is above all useful

In addition, beta blockers are optionally used to treat other diseases:

Who shouldn't take beta blockers (contraindications)

However, beta blockers can have adverse effects on some diseases. This includes the following in particular:

Beta blockers: What are the side effects of the antihypertensive drugs?

Like any highly effective drug, beta blockers also have a number of side effects – but less than previously thought. A study from 2013 showed that of the 33 previously assumed side effects of beta blockers, only five occurred more frequently than with placebo intake. Placebos are called dummy drugs without active ingredients. Accordingly, the following side effects are possible with beta blockers:

Beta blockers and weight gain

In younger people in particular, classic beta blockers such as metoprolol and bisoprolol can cause additional fat deposits to form. The cause of the weight gain is the slowed metabolism. Doctors usually advise affected patients to take another beta blocker that does not have this side effect.

If the beta blocker is used to treat high blood pressure, you can also switch to another antihypertensive drug, such as an ACE inhibitor (Angiotensin Converting Enzyme), be useful. Be sure to talk to your doctor about this problem, as being overweight carries additional risks.

Don't just stop taking beta blockers, but taper off

If the medication is changed or if beta blockers are no longer taken, certain rules must be followed. If, for example, hypertensive patients stop taking beta-blockers suddenly or on their own initiative, the following side effects can occur:

• The blood pressure rises rapidly.
• Dizziness can develop.
• The blood supply to the heart muscle is temporarily weaker, which increases the risk of worsening or even a heart attack in angina pectoris.

Beta blockers should therefore always be tapered off. This means that the dose will be gradually reduced as recommended by the doctor. This will alleviate or go away from the problems some patients call "withdrawal symptoms" when they stop taking beta-blockers.

Beta blockers and alcohol – is it dangerous?

Basically: no alcohol if you have to take medication regularly or only once. Strong drugs such as beta blockers, in particular, can be dangerous when used with alcohol. Because the pleasure poison expands the blood vessels, blood pressure drops. This increases the effect of the beta blockers, but also their side effects. Above all, regular high alcohol consumption in connection with beta blockers is dangerous. Depending on the beta blocker, the consequences of alcohol can include:

Beta blockers and exercise: one thing doesn't preclude the other

Especially when a beta blocker has led to obesity as a side effect, patients want to do sports in order to lose weight again. In principle, this is also allowed while taking beta blockers. However, there are a few things you should consider. Because the beta blocker lowers the heart rate, while exercise increases it.

During exercise, the heart has to beat faster so that sufficient blood and oxygen are available for all cells. However, under the influence of beta blockers, the heart can only moderately increase its frequency. The consequences: During exercise, you may experience shortness of breath, dizziness, exhaustion and pressure on the chest. These are red flags and it is best to stop training once and take it slow the next time.

Nevertheless, people who take beta blockers should by no means forego exercise. Because physical training lowers blood pressure in the long term and strengthens the heart. Newcomers to sports who have to take beta blockers should, however, have their doctor perform a 24-hour ECG before starting training, possibly including a moderate exercise ECG. This shows how the heart works under stress. Correspondingly, the right program for the lowest possible risk training can be put together for beta blocker patients.

Alcohol: be careful with these drugs