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Beta blockers for blood pressure

by Dr Norman Swan

Are older, cheaper, blood pressure-lowering medications just as good as the newer, more expensive drugs?

07 10 2004

There's a big debate about which medications to give people when they have high blood pressure. The pharmaceutical industry pushes newer, more expensive drugs while there's evidence that older, cheaper drugs are as effective, perhaps more so.

One group of such anti blood pressure medications are the beta blockers. You know you're on one of those if its non-brand name ends in -olol, like metoprolol. They work by blocking some of the effects of adrenaline-like chemical messengers from nerves on blood vessels, relaxing the arteries and lowering the pressure.

But it's also thought that this part of the nervous system also induces bone to be absorbed - presumably as a stress response to have calcium ready for action.

So, could beta blockers also block this bone resorption - a potential cause of osteoporosis?

The good news from comparing 30,000 adults with fractures to 120,000 similar people without fractures, is that taking beta blockers plus or minus their frequent companion anti-hypertension drugs, diuretics, was associated with about a 30 per cent reduction in fracture risk. And that was adjusted for many other factors which can affect bone strength.

Not absolute proof, but another reason why cheaper might be better when it comes to blood pressure.

For Reference

Title: Journal of the American Medical Association
Author: Schlienger RG et al, Use of beta-blockers and risk of fractures.
2004, vol 292, pp 1326-1332.