Therapy with beta-blockers
Treatment with beta-blockers has to start “slowly”, ie with low dosages that only increase slowly. The symptoms can also initially worsen. The therapeutic success of a beta-blocker therapy usually only sets in after three months. Beta-blockers should therefore only be given to patients who have been in a stable condition for some time.
Side effects of beta blockers
Beta-blockers must not be administered for certain cardiac arrhythmias , very slow heartbeat, extremely low blood pressure, asthma and some other diseases.
Side effects include, but are not limited to:
- allergic skin reactions
- Fatigue, trouble sleeping, decreased tear flow
- indigestion
- fluctuating blood sugar levels
- increased shortness of breath
- erectile dysfunction
The side effects usually disappear after stopping the drug – for many patients, switching to a drug from another manufacturer also helps. Therefore, during treatment with beta-blockers, patients should be in close contact with their doctor and report any complications directly to him.
Do not use for stress-related high blood pressure
However, in patients whose high blood pressure  is primarily due to stress, treatment with beta-blockers could become problematic if the stress is not addressed. Because this class of drugs can increasingly lead to fatigue and a drop in performance, a vicious circle “stress-high pressure-medication-drop-in performance-higher stress-…” can arise.
Young, dynamic people in particular run the risk of falling into this cycle. The reasons for the high pressure must therefore be clarified before the start of treatment and continuously checked during the treatment.
Beta blockers can be used in a variety of ways
Beta-blockers can also be used for hyperthyroidism, liver cirrhosis with portal hypertension, circulatory disorders in the heart and cardiac arrhythmias.
As the name suggests, beta-blockers block so-called beta-receptors, which are found in many different organs, which results in the diverse areas of application of beta-blockers:
- In the case of an overactive thyroid gland , they are usually only used if there is an increased heart rate (tachycardia). Various common individual preparations with active ingredients such as metoprolol or bisoprolol  can be used for this. A special case is the so-called thyrotoxic crisis, a derailment of an overactive thyroid, which can be triggered, for example, by infections or iodinated contrast media. Then the beta-blocker propranolol is preferably used, which suppresses the production of active thyroid hormones and also counteracts the symptoms of tremor and restlessness that occur with the clinical picture.
- In the case of circulatory disorders in the heart – i.e. coronary heart disease – and after heart attacks, beta-blockers are also used to lower the heart rate. As a result, the heart has to do less work and the oxygen consumption is lower, which makes sense because the reduced blood flow means that the heart is supplied with less oxygen. Many of the common beta-blockers can also be used as a single preparation.
- The same applies to various forms of cardiac arrhythmias  in which the heart rate is increased (e.g. in atrial fibrillation ).
- In liver cirrhosis with portal hypertension, on the other hand, propranolol is usually used, and carvedilol is used more rarely. Both of these beta-blockers lower the pressure in the portal vein by causing the vessel to widen.
Beta-blockers as combination preparations
Beta blockers are often on the market as combination preparations. Combination preparations usually combine beta-blockers with a diuretic (hydrocholorothiazide; HCT) and are particularly useful in the treatment of high blood pressure, since HCT lowers blood pressure. They are also used for moderate to severe heart failure  when fluid retention occurs.
