Beta Blockers

Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases.

Beta blockers block the action of epinephrine and norepinephrine on the ß-adrenergic receptors in the body (primarily in the heart, peripheral blood vessels, bronchi, pancreas, and liver). The hormones and neurotransmitters stimulate the sympathetic nervous system by acting on these receptors.

There are three types of beta receptors: ß1-receptors located mainly in the heart, and ß2-receptors located all over the body, but mainly in the lungs, muscles and arterioles. ß3-receptors are less well characterised, but have a role in fat metabolism.

Activation of ß1-receptors by epinephrine increases the heart rate and the blood pressure, and the heart consumes more oxygen. Drugs that block these receptors therefore have the reverse effect: they lower the heart rate and blood pressure and hence are used in conditions when the heart itself is deprived of oxygen. They are routinely prescribed in patients with ischemic heart disease. In addition, beta blockers prevent the release of renin, which is a hormone produced by the kidneys which leads to constriction of blood vessels.

Drugs that block ß2 receptors generally have a calming effect and are prescribed for anxiety, migraine, esophageal varices and alcohol withdrawal syndrome, among others. Many beta blockers affect both type 1 and type 2 receptors; these are termed non-selective blockers. Selective beta blockers primarily affect ß1-receptors. Selective beta blockers gradually become less selective at higher doses.

Non-selective beta blockers should not be used in patients with asthma or any reactive airway disease. Doing so can precipitate bronchospasm by blocking the ß2 mediated relaxation of the bronchiole muscles.

Since they lower heart rate, beta blockers have been used by some Olympic marksmen to provide more aiming time between heart beats.

Some musicians use beta blockers to avoid stage fright and tremor during auditions and performances.

Beta blockers decrease nocturnal melatonin release.

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