Problems requiring beta- or alpha-blockers
I have severe asthma and my doctor would not put me on beta-blockers for my raised BP. Why should these drugs be avoided in people with asthma?
Beta-blockers increase airways obstruction in people with recognized or latent asthma. However, as beta-blockers have different effects on the airways (known as ‘selective’ or ‘nonselective beta-blockers’), some types of beta-blockers are more harmful than others. Some people with chronic bronchitis or emphysema also have unrecognized asthma. There have been deaths from using beta-blockers in these people, so before starting beta-blockers, the doctor will measure airways resistance in anyone with any kind of bad chest. More often than not, there are alternative BP-lowering agents that can be used in these situations.
Generally speaking selective beta-blocker agents, i.e. drugs that act only on the heart rather than on the lung airways, are preferred to non-selective agents. Non-selective beta-blockers must be avoided in people with asthma or obstructive airways disease. Selective beta-blockers can be used in certain circumstances where alternative BP-lowering drugs are not available or where obstructive airways disease can only be improved slightly.
I suffer from migraine every month. I have now been diagnosed with high BP. Will this affect which drugs I am prescribed?
Beta-blockers are used to prevent the onset of migraines headache. For this reason they are generally preferred for people who suffer from migraines and high BP, so you will probably be offered these first to see how you get on.
I have been given beta-blockers for my high BP and found later that I had real problems making love to my wife. Would it have been the drugs that were causing my erection problems? Could I be given something else for the BP?
You are quite correct. Beta-blockers are associated with erection problems but to a lesser extent than diuretics. As many as 15–20% of men taking high dose diuretics (e.g. 5 mg bendrofluazide) experience it. If you are having problems in this department, do go to your doctor and discuss them because there will be other drugs that you could be prescribed instead.
I suffer from prostatic symptoms. Are there some BP-lowering drugs more suitable for me?
Alpha-adrenoceptor blocking drugs have the effect of reducing BP and simultaneously relieving symptoms of prostate obstruction. However, trials of alpha-blockers have not been good, apparently increasing risk of heart failure. They are not given if you suffer from heart failure. Your doctor will be able to discuss what other types of drugs are available.
