Taking Propranolol for High Blood Pressure
Written by: Hussain Abdeh MPharm: 2211840
Published on: 04/05/2021
Updated on: 04/05/2021
Propranolol is a type of prescription only beta-blocker and can be used to treat a wide range of conditions. Most commonly it is prescribed to treat high blood pressure (hypertension), anxiety and migraines.
In this article, we will be looking at how propranolol is used to treat high blood pressure and its effectiveness in doing so. As with all medicine, propranolol may cause several side effects if taken incorrectly, we will also be touching on what side effects to look out for when taking propranolol for high blood pressure.
What is high blood pressure (Hypertension)?
Blood pressure is the exact reading and measurement of force that your heart uses when pumping blood around your body. Blood pressure is measured in millimetres of mercury (mmHg) using two figures/numbers, often referred to as a top number and a bottom number.
The top number relates to Systolic Blood Pressure which is the pressure and force your heart uses when pumping blood around your body.
The bottom number relates to Diastolic blood pressure which is the blood pressure reading when your heart rests in between beats.
You are considered to have a high blood pressure with a reading in the region of 140/90mmHg or higher. To put this into perspective, a normal blood pressure reading is 90/60mmhg.
Having high blood pressure increases the risk of serious health issues such as a heart attack or stroke. It is usually at this point where you will be advised to make lifestyle changes or may be prescribed high blood pressure treatments such as propranolol to help control your blood pressure and reduce it back down to the normal level.
Typically, high blood pressure means that your heart needs to use more force to pump blood around your body.
High blood pressure is usually the result of an unhealthy lifestyle, and can be caused by smoking, eating fatty foods, being overweight, consuming too much alcohol and not getting enough exercise. However, it can also be genetic with individuals of Caribbean or African descent being more likely to develop high blood pressure, among others.
How does Propranolol help people with High Blood Pressure?
Propranolol belongs to the beta-blocker family of drugs, to find out more about beta blockers and how they work, you can read our guide to beta blockers.
As a beta blocker, propranolol works by blocking the beta-adrenergic receptor, which is responsible for responding to adrenaline, the body’s natural stress hormone. Adrenaline increases the rate at which the heart beats and makes it beat harder, as a result directly increases blood pressure.
Propranolol gets to work by blocking messages sent to your heart by various nerves around the body. Your heart receives those messages in a tiny area called the beta-adrenergic receptor which then processes those messages and increases your heart rate. By blocking the beta-adrenergic receptor, the messages sent to your heart are also blocked, this slows the heart rate and the force of its contractions with every heartbeat.
Blood pressure is reduced with the heart beating at a reduced rate, contracting with less force, and pumping smaller amounts of blood around the body with each beat.
Propranolol is used to treat high blood pressure mainly in patients that have previously suffered heart complications such as a heart attack or heart failure. Although propranolol lowers blood pressure, it is not necessarily recommended as the first line treatment for uncomplicated blood pressure. This means that if you just have high blood pressure, with no other complications, an alternative high blood pressure medicine such as a thiazide diuretic or ACE inhibitor may be a better suited alternative.
When taking propranolol to lower your blood pressure, the starting dose is usually 80mg twice daily. Your doctor will monitor how much propranolol lowers your blood pressure and make tweaks to your daily dosage accordingly. For example, if your blood pressure does not go down, you may be prescribed with a higher dosage of propranolol, usually 160mg twice daily to successfully lower your blood pressure.
Why is propranolol not a first line treatment for High Blood Pressure?
Propranolol is typically prescribed to treat complicated blood pressure in individuals who have previously suffered with other heart conditions such as a heart attack or heart failure. When treating uncomplicated blood pressure, propranolol has a relatively weak effect when compared to other treatment options in reducing some of the other complications that can develop due to high blood pressure such as stroke or coronary artery disease.
As a result, first line treatments for high blood pressure include calcium channel blockers and thiazide diuretics which are more effective in treating high blood pressure complications.
How quickly does propranolol work for high blood pressure?
Propranolol is a fast-acting medicine and gets to work within just a few hours. Propranolol can take anywhere from a few days to several weeks to successfully lower high blood pressure. This is partly due to your doctor starting you off on a lower dosage and gradually increasing that dosage over the space of a few days/weeks. Some individuals may find that the lower dosage of propranolol is able to control their blood pressure quickly, whilst others may need their dosage gradually increasing.
As per the NICE Guidelines, the typical starting dosage for propranolol when treating high blood pressure is 80mg twice daily. If the starting dose is unable to reduce/control your blood pressure, the dose should be increased at weekly intervals as directed by your doctor.
The typical maintenance dose for propranolol when treating high blood pressure is 160mg-320mg to be taken at equal intervals daily.
As with all medicine, propranolol can cause several different side effects, however; most people will only experience very few or minor side effects. Side effects are often worse when taking a medicine for the first time, over time your body will learn how to cope with the side effects the more frequently that you take a certain medicine.
Common side effects will typically impact more than 1 in every 100 people, they are usually very mild and short lived lasting only a few hours. If you find that you are experiencing mild side effects for a few days after taking propranolol for high blood pressure you should speak to your doctor or pharmacist.
Common side effects include:
- Tiredness, lethargic, lightheaded or dizziness
- Difficulty sleeping
- Cold fingertips or toes (blood supply to your fingers and toes may be affected when taking propranolol
Serious side effects
In the rare occurrence that you experience any side effects that are serious you should call a doctor straight away if:
- You experience shortness of breath when carrying out simple tasks such as walking up the stairs or uphill. Wheezing and tightening of the chest
- You start to experience chest pain or an irregular heartbeat, this could indicate an underlying heart problem
- Yellow tint to the whites of your eyes or skin, this can indicate an underlying liver problem
Serious allergic reaction
Immediately call 999 or go to your nearest A&E if you experience:
- Swelling of the mouth, face, lips tongue or throat
- You experience any breathing difficulties
- Tightness of the chest, wheezing or any tightness of the throat
- You develop a skin rash that is sore to touch, itchy, red, swollen
- Any blistering or peeling of the skin
If you have any of the above side effects, you could be experiencing a serious allergic reaction (anaphylaxis) that will require immediate hospital attention.
For a full and extensive list of the side effects please read our medical guide on propranolol side effects.
If you experience any side effect not contained in the above list, or the patient information leaflet, you can report this to the MHRA using their Yellow Card Safety Scheme.
The key takeaway from this article is that propranolol is an effective treatment for high blood pressure, however there are some instances and complications that may mean propranolol is not the best fit for you.
Propranolol is better suited to treat complicated high blood pressure in individuals who have experienced heart complications. Propranolol is particularly effective for individuals who have suffered a heart attack, its beta-blocker properties help to regulate heart rate and reduce pressure on the heart. As a result, blood pressure is also reduced with the heart using less force per contraction and beating at a more regular rate.
Propranolol is a fast-acting medicine, typically getting to work within just a few hours; however, it may take a few days to successfully lower blood pressure. It is a relatively low risk medicine with very few side effects, most side effects that do appear are common and will subside within a few hours/days.
You should always ensure that you are purchasing propranolol or any other beta blocker from a fully regulated pharmacy or online pharmacy such as Medicine Direct. By doing so, our team of qualified pharmacists and prescribers will ensure that you are prescribed the correct dosage to treat your specific condition.
Propranolol patient information leaflet - https://www.medicines.org.uk/emc/files/pil.2903.pdf
Is propranolol the most suitable treatment option for High Blood Pressure? We explain how propranolol helps treat high blood pressure, how quickly it treats it and any potential side effects that may appear.
Propranolol can provide treatment for a wide range of conditions; however, it may not be the first line treatment option for your specific condition. If you are looking to purchase propranolol to treat a specific condition, please complete our online consultation with as much information as possible.
Our UK based prescribers will then be able to prescribe the most suitable medicine to treat your condition.