VIDEO: Beta Blocker Tolerability, Efficacy Key in Selection, But Vary Across Drugs

In selecting specific beta blockers for patients with heart failure, Jeffrey S. Borer, MD, of the Howard Gilman Institute for Heart Valve Disease, says cardiologists should primarily consider the drug’s tolerability and its effectiveness shown in testing, though he cautions many beta blockers don’t fit the latter criteria.

“Not every beta blocker has been tested, and not all beta blockers were created equal,” Borer explains. “If they were, we wouldn’t have more than one on the market.”

Borer notes every drug for high blood pressure has “a variation in tolerability and a variation in effectiveness,” because there must be “some difference in one drug or a group of drugs from another in order for regulatory authorities to consider approving the new drug.”

Though Borer says it’s risky for a cardiologist to justify using a beta blocker that hasn’t been tested for efficacy in heart failure patients, he says the same standard of scrutiny should be used in tolerability tests, because “other than that, there’s no objective basis for selecting one beta blocker over another beta blocker for somebody with heart failure.”