Two million warned over blood pressure tablets

Last updated at 23:33pm on 27th June 2006

Two million Britons are to be taken off blood pressure drugs after studies showed they increase the risk of strokes, heart attacks and diabetes.

From today, beta blockers will no longer routinely be prescribed for high blood pressure.

The dramatic change in guidance follows evidence that the drugs taken daily by millions of Britons are only half as effective at stopping strokes than a host of newer pills.

Beta blockers such as atenolol also raise the risk of stroke and of developing diabetes, compared with other blood pressure tablets.

New guidelines from the National Institute for Health and Clinical Excellence make the newer drugs the first choice treatment for the six million Britons treated for high blood pressure.

From today, a new generation of drugs including ACE inhibitors, diuretics and calcium channel blockers will become the standard medication for high blood pressure.

Few new patients will be given beta blockers and doctors expect almost all of the two million currently taking the drugs for high blood pressure to be switched.

Doctors have stressed that the switch-over will be gradual - and there is no need for patients to contact their GP before their next scheduled check-up.

Beta blockers, which have been a fixture of the treatment of high blood pressure for more than three decades, will remain the treatment of choice for other conditions such as angina.

Experts say new guidelines from the National Institute for Health and Clinical Excellence will ensure patients get the best treatment possible - and so save thousands of lives a year.

Professor Graham McGregor, of the Blood Pressure Association, said:'This is great news for patients with high blood pressure.

'We know that the drugs now being prescribed have fewer side-effects and are more effective. Patients are more likely to take them.

'We will be saving thousands of patients dying from strokes, heart attacks and heart failure and prevent patients from suffering strokes, heart attacks and heart failure.'

It is estimated that more than 60,000 lives are lost a year through the use of drugs that do not control blood pressure properly.

Studies have shown that beta blockers are only half as effective at stopping strokes as other blood pressure treatments.

Last year, a study of 20,000 patients showed that treatment with beta blockers cut the risk of stroke by 20 per cent, compared to no treatment at all.

In contrast, the newer treatments prevent 40 per cent of strokes and 15 per cent more heart attacks.

Diabetes risk

Patients on beta blockers are also up to 30 per cent more likely to develop diabetes.

Beta blockers such as atenolol, bisoprolol and metoprolol also have worse side effects, including fatigue, loss of libido and impotence.

Professor Bryan Williams, who helped draw up the new guidelines, said: 'For the majority of patients, we no longer recommend beta blockers as a first line option for treatment.

'They are less effective at controlling blood pressure, less effective at preventing events (strokes and heart problems) and they are more likely than other treatments to increase the risk of developing diabetes.

'The recommendations have undergone a cost-effectiveness analysis which has reinforced the guidance.

'It is no longer a case of "can we afford to do it", but more, "can we afford not to do it?"

'The decision to recommend that beta blockers should not longer be used as a routine initial treatment for high blood pressure is a bold decision and the correct decision.'

It is estimated the switch will cost the NHS add £58million to the £93million annual bill for beta blockers. However, this will be more than recouped by the £280million saved a year in the treatment of strokes, heart attacks and diabetes.

The change-over will be gradual, with those who are not performing well on beta blockers being among the first to switch.

Doctors may also recommend that those with a higher risk of diabetes - such as obese patients - make the change.

Over time, patients are expected to vote with their feet, leading to almost all of those on beta blockers for high blood pressure coming off the drugs.

Prof McGregor said: 'If you have high blood pressure, if you are told the drug you have is less effective in reducing strokes and 30 per cent more likely to cause diabetes than other drugs and then asked which drug you would rather be on, the answer is blindingly obvious.'

However, beta blockers will continue to be recommended to treat angina and to reduce the risk of further heart attacks in heart attack survivors.

The drugs are also likely to be the most suitable treatment for blood pressure in women who may become pregnant.

Any changes will be made at the patient's next six-monthly check-up and doctors stress that patients should not make any changes themselves.