Wednesday, June 28, 2006

Medicine: beta-blockers blocked by Brits?

In this week's edition of Everything You Learned In Med School Was Wrong, a division of the NHS, the National Institute for Clinical Excellence (NICE), is recommending that beta-blockers no longer be prescribed as first-line hypertension therapy. Their recs:

Patients aged 55 and over and those of African or Caribbean descent should be given a calcium channel blocker or a thiazide-type diuretic initially. Those under 55 should be given an ACE inhibitor or an angiotensin receptor blocker.
The argument, which isn't bad, is that beta-blockers come with far too many side-effects: increased risk of type II DM, loss of energy, libido, and "enjoyment of life" (interesting side-effect).

I'm not sure why the cardioprotective properties of beta-blockers vs. calcium channel blockers isn't factoring in here, mainly because this is a nice article for the lay public and not the slightly less lay-med psychiatrist-to-be. And this is the Brits. But wowsers.

1 comment:

Matz said...

From my understanding that makes sense. Beta blockers really aren't great for primary prevention of MI's and strokes. They are much better at reducing heart rate and myocardial oxygen demand then they are at affecting blood pressure. Thus they make total sense for secondary prevention following a heart attack, but if someone just has hypertension (with no history of MI) then they'll get more bang for their buck with an ACE or CCB.