September 23, 2018

Ask The Doctor > Questions & Answers > Beta-blockers are no longer first line treatment for hypertension

Beta-blockers are no longer first line treatment for hypertension

Patient: This question is for a cardiologist. What would you recommend for blood pressure medicine for first timeusers. My blood pressure seems to spike when I go to the doctor and basically it is 120.80 to 139/ 84 at home most days. The doctor put me on Meteprolol which is helping me sleep well and feel so much calmer. I have a new option now of taking Hydrochlorothiazide. I am just confused and concerned. So my question really is which one would have the least long term side effects on my body?



Doctor: I would initially recommend a 24 hour ambulatory BP monitor to measure your blood pressure throughout the day, to see if hypertension (high blood pressure defined as >140/90mmHg) is consistently present. Hypertension treatment guidelines follow the ACD rule. In someone of your age, initial therapy could be with either a Calcium channel blocker or Diuretic (Hydrochlorothiazide). Beta-blockers are no longer first line but may be used as additional therapy usually if a patient has angina, history of previous heart attack or heart failure. I would recommend discussing these options with your family doctor, in addition to lifestyle modifications.




Dr. Jimmy Obaji M.D.

Dr. Jimmy Obaji completed his residency in Family Medicine at the University of Manitoba. He currently operates a walk-in-clinic in downtown Toronto.

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