Beta blockers are a class of drugs used to treat various types of heart disease. Coronary artery disease, congestive heart failure, and arrhythmias are types of heart disease in which beta blockers are used to improve heart function and prevent complications from the disease process. The American Heart Association reports beta blockers may be used alone or in combination with other drugs to improve effectiveness.
Carvedilol
Carvedilol is a beta blocker used to treat congestive heart failure (CHF). Carvedilol causes vasodilation, or relaxation of blood vessels, thereby decreasing the work load of the heart. By dropping blood pressure, more oxygen-rich blood can reach the body, especially the heart. These effects help reduce the incidence of chest pain and irregular heart rhythms associated with CHF.
The Association of Healthcare Research and Quality supports the use of beta blockers such as carvedilol in heart disease because patients with coronary artery disease and congestive heart failure who remained on beta blockers following initial treatment of their heart disease showed a decreased death rate compared to those patients who were not placed on long term beta blocker therapy.
Billie Ann Wilson, Ph.D., Margaret Shannon, Ph.D., and Kelly Shields Pharm.D., authors of the 2010 Pearson Nurse's Drug Guide, discuss the common side effects of beta blockers such as carvedilol. Bradycardia, a heart rate below 60 beats per minute, and low blood pressure are common and problematic side effects for patients taking carvedilol. Dizziness and syncope, or fainting, are also common adverse reactions. Bronchospasm, or narrowing of airways, is a potential adverse reaction to beta blockers. Patients who have a history of asthma should use carvedilol cautiously.
Sotalol
Sotalol is a beta blocker with powerful anti-arrhythmic properties. This means sotalol is used to control irregular heart rhythms. There are certain dangerous irregular heart rhythms that can be fatal if not corrected immediately; for example ventricular tachycardia and ventricular fibrillation. Sotalol is used to treat these arrhythmias. However, because of sotalol's dangerous side effects, it is given initially in the hospital setting under close supervision.
Dangerous side effects include heart block, worsening of congestive heart failure symptoms, bradycardia and chest pain. Ironically, sotalol can cause a lethal arrhythmia called Torsades de Pointe or polymorphic tachycardia. With this arrhythmia, multiple irritable areas in the ventricles are sending many signals causing a very rapid heart rate.
Other arrhythmias such as atrial fibrillation may not be immediately life threatening, but over time, cause serious complications such as heart failure or stroke. Sotalol may be used to treat this type of arrhythmia, but given its dangerous adverse effects, other medications may be tried first.
Metoprolol
Metoprolol is used primarily to control hypertension and chest pain in patients with history of coronary artery disease and heart attack. Metoprolol is prescribed to reduce the risk of death following a heart attack. Side effects and adverse reactions are similar to those of carvedilol.
References
- Agency for Healthcare Research and Quality: Long-term Use of Beta Blockers
- American Heart Association: Blood Pressure Lowering Drugs
- "Pearson Nurse's Drug Guide 2010"; Wilson, B. A., Shannon, T. M., & Shields, K. M.; 2010
