Beta Blocker for Treating Patients With Angina

Beta blockers are a prescription medications used to thwart the effect of the stress hormone adrenaline on the heart. Because of their effect, beta blockers may be used to treat angina, or chest pain—a symptom often associated with coronary artery disease (CAD), or when the arteries that supply the heart become partially or fully blocked.

Man sitting on couch with hand on his chest.
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This article explains why beta blockers are used to treat angina. It also covers what effect beta blockers have on angina, as well as potential side effects.

Why Are Beta Blockers Used for Angina?

In stable angina, one or more of the coronary arteries are partially blocked by an atherosclerotic plaque, which is made up of fat and other substances.

Typically, the heart muscle supplied by the impacted artery gets enough blood flow during periods of rest. But during exercise or periods of stress, the partial blockage prevents the blood flow from increasing enough to supply the heart with needed oxygen. As a result, angina occurs.

In individuals with stable angina, beta blockers are considered first-line therapy.

Beta blockers work by blocking the effect of adrenaline on the heart. This results in two major benefits including:

  • Slowing of the heart rate, in particular during periods of exercise or stress
  • Reducing the force of heart muscle contraction

Both of these reduce the amount of oxygen needed by the heart muscle. As a result, angina and ischemia, which is when there is not enough blood flow to an organ, are delayed or prevented.

What Is the Effect on Angina?

Beta blockers have several effects on angina:

  • Beta blockers are often effective in improving the intensity or duration of exercise that can be done without developing ischemia or angina.
  • In individuals with angina who have had a heart attack, beta blockers have been shown to reduce the risk of having another one.
  • Studies suggest that beta blockers are helpful in preventing death related to heart attack or heart failure (when the heart doesn't pump enough blood) in those with stable angina.

What Are the Side Effects of Beta Blockers?

In general, beta blockers are considered safe to take. Lower doses are associated with reduced side effects.

Common side effects of beta blockers may include:

There are different types of beta blockers available. In some heart conditions, certain beta blockers are not recommended. For example, in individuals with vasospastic angina, which describes when there is a spasm in the coronary artery, certain beta blockers can occasionally cause more spasms.

Many of these side effects may be avoided by using beta blockers that work primarily on the heart itself, also known as cardioselective beta blockers. Unlike other beta blockers, these tend to have little effect on the blood vessels and lungs. Examples of these beta blockers include Tenormin (atenolol) and Lopressor (metoprolol tartrate).

Summary

Beta blockers are used to block the effect of adrenaline on the heart, particularly during exercise. This results in a slowed heart rate, as well as the reduced force of the heart muscle contraction. These effects help delay or prevent both ischemia and angina.

Beta blockers may also reduce the risk of having another heart attack, as well as preventing heart condition-related death. These medications are generally well tolerated.

Frequently Asked Questions

  • What is considered first-line treatment for angina?

    Beta blockers are considered first-line treatment for angina.

  • Which beta blockers are typically used for angina?

    There are a variety of beta blockers available to treat angina. "Cardioselective" options may be used to decrease the chance of side effects in some individuals.

  • Can beta blockers be used to treat variant angina?

    Research suggests that some types of beta blockers may lead to more spasms in variant angina, which is also called vasospastic angina.

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8 Sources
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  1. Wee Y, Burns K, Bett N. Medical management of chronic stable angina. Aust Prescr. 2015;38(4):131-6. doi:10.18773/austprescr.2015.042

  2. American Heart Association. How do beta blocker drugs affect exercise?

  3. Frishman WH. Beta-adrenergic blockersCirculation. 2003;107(18). doi:10.1161/01.CIR.0000070983.15903.A2

  4. Kezerashvili A, Marzo K, De Leon J. Beta blocker use after acute myocardial infarction in the patient with normal systolic function: when is it “ok” to discontinue? Curr Cardiol Rev. 2012;8(1):77-84. doi:10.2174/157340312801215764

  5. Chatterjee S, Biondi-zoccai G, Abbate A, et al. Benefits of β blockers in patients with heart failure and reduced ejection fraction: network meta-analysis. BMJ. 2013;346:f55. doi:10.1136/bmj.f55

  6. Harvard Health Publishing. Beta blockers: cardiac jacks of all trades.

  7. Kook H, Hong SJ, Yang KS, Lee S, Kim JS, Park CG. Comparison of nebivolol versus diltiazem in improving coronary artery spasm and quality of life in patients with hypertension and vasospastic angina: a prospective, randomized, double-blind pilot study. Fukumoto Y, ed. PLoS ONE. 2020;15(9):e0239039. doi:10.1371/journal.pone.0239039

  8. Ladage D, Schwinger RHG, Brixius K. Cardio-selective beta-blocker: pharmacological evidence and their influence on exercise capacity: cardio-selective beta-blockerCardiovascular Therapeutics. 2013;31(2):76-83. doi:10.1111/j.1755-5922.2011.00306.x