Beta-blockers Should Not Be First Line Treatment For Hypertension
Beta-blockers should not be routinely used for the treatment of high blood pressure, says the National Institute for Health and Clinical Excellence (NICE), UK. NICE is the NHS watchdog for England and Wales.
The new NICE guidance says there are other medications which are better for treating hypertension. 40% of adults in England and Wales suffer from high blood pressure.
(Hypertension = High Blood Pressure)
According to NICE, beta-blockers raise a patient’s risk of developing diabetes.
The watchdog stresses that patients must keep taking their beta-blockers until they see their doctors.
The guidance, which was published in 2004, has been updated after NICE and the British Hypertension Society decided that the guidance’s section which deals with hypertension medications needed a further update. The hypertension section was supposed to have its next update in three years’ time – however, as a result of new research NICE decided to bring this forward.
Recent research carried out in 2004 showed that new drugs were much better at treating high blood pressure. According to NICE, Beta-blockers are not the best drugs around for hypertension, especially for elderly patients.
At present there are about two million patients in the UK who are receiving Beta-blockers for hypertension.
Patients need to know that Beta-blockers are also used for heart failure and angina. The drugs are still indicated for those conditions. The new guidance only refers to the use Beta-blockers for treating hypertension.
The new updaded guidelines include the following:
— Hypertensive patients aged 55 or more, or Black patients of all ages. First line of choice of initial therapy should be either a calcium channel blocker or a thiazide-type diuretic. (Black patients – does not include patients of mixed race or Asian patients).
— Hypertensive patients under 55. First choise initial therapy should be an ACE inhibitor ((or an Angiotensin receptor blocker if an ACE inhibitor is not tolerated).
— If initial therapy was with a calcium channel blocker or thiazide-type diuretic and a second drug is required, add an ACE inhibitor (or an Angiotensin receptor blocker if an ACE inhibitor is not tolerated). If initial therapy was with an ACE inhibitor, add a calcium channel blocker or a thiazide-type diuretic.
— If treatment with three drugs is required, the combination of ACE inhibitor (or an Angiotensin receptor blocker if an ACE inhibitor is not tolerated), calcium channel blocker and thiazide-type diuretic should be used.