November 23, 2020/Heart Health

Beta-Blockers: Why You Need Them for Heart Failure

And why skipping doses is a bad idea

heart care and beta blockers medication

Beta-blockers are some of the most effective medications for treating chronic heart failure. Chances are, your doctor has prescribed a beta-blocker for you if you’ve had a heart attack or have:


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Beta-blockers are drugs that can slow your heart rate and keep it from overworking. They also can stop your heart from responding to stress hormones, such as adrenaline. Over time, beta-blockers may help your heart pump better.

“Beta-blockers remain one of the most important drugs we prescribe, because in the long term they help patients live longer,” says cardiologist W.H. Wilson Tang, MD.

Your doctor might prescribe other medicines along with beta blockers to improve your heart failure symptoms, such as:

  • Aldosterone antagonists: These medicines block hormones that make your heart failure worse. They cause your kidneys to make more urine, which flushes excess salt and water out of your body and makes it easier for your heart to pump.
  • Angiotensin receptor-neprilysin inhibitors (ARNI): These combination medicines help your heart pump blood better so that you can have fewer symptoms as you carry out your everyday activities.
  • Sodium-glucose cotransporter 2 inhibitors (SGL2T-i): This newer class of drugs may help your heart work better. If you have diabetes, they will also help lower your blood sugar.

These drugs are pillars of heart failure treatment and lower your risk of a cardiovascular event.

Beta blockers: use as directed

When you start taking beta-blockers, your symptoms may become slightly worse for about two to three weeks as your heart adjusts to them. You might feel more tired or dizzy. That’s normal. However, you’ll need to check your blood pressure and heart rate to make sure they don’t drop too low.

It’s critical to take beta-blockers as directed. Even if you think they aren’t working or aren’t making you feel better, they’re helping prevent your heart disease from getting worse.

It’s especially important to continue beta-blockers if you’ve been taking them long-term. Studies show that abruptly stopping them can cause chest pain and increase your risk of sudden cardiac death.

So, don’t stop taking your beta-blockers unless you discuss it with your physician – even if they’re causing side effects such as:

  • Dizziness or lightheadedness.
  • Tiredness.
  • Cold hands and feet.
  • Headache.
  • Nightmares or difficulty sleeping.
  • Nausea, vomiting, heartburn, diarrhea, constipation or gas.
  • Sudden weight gain (such as gaining three or more pounds in one day, or gaining weight for more than two days).
  • Difficulty breathing, increased shortness of breath or wheezing.
  • Skin rash.
  • Slow, fast or irregular heartbeat.
  • Swelling of feet and lower legs.
  • Chest pain — but contact your doctor or nurse right away.


If any of these side effects are severe or don’t go away, talk to your doctor about how to control them. Sometimes your doctor can:

  • Lower your beta-blocker dosage.
  • Adjust your other medications.
  • Recommend alternate ways to take your beta-blocker so it doesn’t interact with other medications.


The No. 1 reason people (wrongly) stop taking beta-blockers

“The top reason patients stop using beta-blockers is admission to the hospital – for various conditions, not just heart failure,” Dr. Tang says. “However, most people should not stop, even if they are hospitalized, unless the doctors decided that it is more harm than good.”

Research shows that patients fare better when they continue taking beta-blockers while in the hospital, even with acute heart failure.

“An inability to tolerate beta-blockers indicates a worsening heart condition,” says Dr. Tang. “Other testing may be necessary to determine if the heart is too weak for beta-blockers.”

This may even apply for patients whose heart function has recovered to the normal range. “Recent clinical studies have shown that, even in those with full recovery of their heart structure and function, stopping drugs like beta-blockers can reverse the recovery course and can be detrimental,” he adds.

Resuming beta-blockers isn’t so easy

If you stopped taking beta-blockers, re-determining the correct dosage is a complicated process. While it’s important that you resume beta-blockers, you will need to closely follow instructions from your doctor. Doctors have learned to start low and go slow in increasing the dose so that your body can readjust to the drug.

In general, doctors have learn to start low and go slow in increasing the dose so that you body can readjust to the drug.

“How much and how quickly to increase the dose will depend on your medical condition,” says Dr. Tang. “It can take time and even adjustment of other medications in order to maintain adequate blood pressure.”

Your best precaution? Make sure you always have enough beta-blocker medication on hand. Running out – or simply not taking your medication – can be dangerous.


Learn more about our editorial process.

Related Articles

Pill bottle with beta blockers.
September 5, 2022/Mental Health
Do Beta-Blockers Work for Anxiety?

Medicine intended for your heart may help in certain anxiety-provoking situations

Person reclining on couch wearing compression socks
April 3, 2024/Heart Health
How To Raise Your Blood Pressure Immediately at Home

First things first — slowly sit or lie down

Older couple talk while leisurely walk across a bridge
February 29, 2024/Heart Health
Can You Exercise After a Heart Attack?

Absolutely! In fact, in many ways, exercise is key to recovery

Person having a heart attack in background, close up of hand calling 911 on cell phone in foreground
February 28, 2024/Heart Health
Can You Stop a Heart Attack Once It Starts?

There’s no way to stop it once a heart attack is happening, but the most important thing you can do is to call for help

Person enjoying container of assorted fruit
February 28, 2024/Heart Health
How To Protect Your Heart When You Have Prediabetes

You can counter the risk of prediabetes-related heart attack or stroke by eating more fruits, vegetables and whole grains, as well as exercising regularly

Blood pressure cuff on arm and blood pressure-reading device
February 27, 2024/Heart Health
Here’s What Your Blood Pressure Numbers Mean

An ideal blood pressure is less than 120 mm Hg systolic and less than 80 mm Hg diastolic

Person taking heart health quiz on a clipboard
February 26, 2024/Heart Health
How Healthy Is Your Heart? Take This Quiz To Find Out

Age, sex and genetics are just a few factors that can affect your risk of developing coronary heart disease

Cholesterol blocking blood flow in artery
February 26, 2024/Heart Health
What It Means if You Have ‘Sticky’ Cholesterol

LDL cholesterol and lipoprotein (a) cholesterol are more likely to stick to your arteries and lead to dangerous heart events

Trending Topics

Person in yellow tshirt and blue jeans relaxing on green couch in living room reading texts on their phone.
Here’s How Many Calories You Naturally Burn in a Day

Your metabolism may torch 1,300 to 2,000 calories daily with no activity

woman snacking on raisins and nuts
52 Foods High In Iron

Pump up your iron intake with foods like tuna, tofu and turkey