Beta-blockers are an important class of drug used mainly in the management of cardiovascular disorders.

Indications

• angina
• post-myocardial infarction
• heart failure: beta-blockers were previously avoided in heart failure but there is now strong evidence that certain beta-blockers improve both symptoms and mortality
• arrhythmias: beta-blockers have now replaced digoxin as the rate-control drug of choice in atrial fibrillation
• hypertension: the role of beta-blockers has diminished in recent years due to a lack of evidence in terms of reducing stroke and myocardial infarction.
• thyrotoxicosis
• migraine prophylaxis
• anxiety

Examples

• atenolol
• propranolol: one of the first beta-blockers to be developed. Lipid soluble therefore crosses the blood-brain barrier

Side-effects

• bronchospasm
• cold peripheries
• fatigue
• sleep disturbances, including nightmares
• erectile dysfunction

Contraindications