Beta blockers are a class of antihypertensive medication used to treat hypertension and other heart conditions.1 They are one of the most commonly prescribed class of antihypertensive in the US.2,3 Metoprolol was the sixth most prescribed medication in the US in 2016 with 88 million prescriptions.3 The number of prescriptions grew every year from 2012 to 2016 by one to two million prescriptions a year.
In the US, overall use of beta blockers as a monotherapy or as a part of combination therapy was 20.3% (1.3 standard error [SE]) in 2001 – 2002 and grew to 31.9% (1.6 SE, ptrend<0.01) in 2009 – 2010.2 Metoprolol was the most commonly used beta blocker in 2009 – 2010 with a prevalence of 15.1% (0.8 SE).
According to the 2017 hypertension guideline by the American College of Cardiology (ACC) and American Heart Association (AHA), beta blockers are not recommended as a first-line therapy for adults with hypertension.4 They are listed as secondary oral antihypertensive drugs. In the 2013 guideline for the management of heart failure, the ACC/AHA recommended beta blockers as a long-term treatment method for patients with heart failure with reduced ejection fraction (HFrEF).5 An update of the guideline in 2017 by the ACC, AHA, and the Heart Failure Society of America reiterated the 2013 recommendation.6
References
- U.S. National Library of Medicine. Beta Blockers (Beta-Adrenergic Antagonists). PubMed Health. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0025465/. Accessed October 2, 2018.
- Gu Q, Burt VL, Dillon CF, Yoon S. Trends in antihypertensive medication use and blood pressure control among United States adults with hypertension: the National Health And Nutrition Examination Survey, 2001 to 2010. Circulation 2012; 126 (17): 2105-2114.
- Aitken M, Kleinrock M. Medicines Use and Spending in the U.S.: A Review of 2016 and Outlook to 2021. 2017.
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018; 71 (19): e127-e248.
- Writing Committee M, Yancy CW, Jessup M, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;128(16):e240-327.
- Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2017;136(6):e137-e161.
