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In a recent column you mentioned that beta-blockers were prescribed to treat angina

In a recent column you mentioned that beta-blockers were prescribed to treat angina. I'm now worried as I take this medication, but I don't have angina. Has my doctor made a mistake?

Beta- blockers are used to treat a wide range of problems, including angina, high blood pressure, abnormal heart rhythms, and heart muscle disorders. In addition, they may be prescribed to prevent migraine and to decrease the physical symptoms associated with anxiety or panic disorder. Given in eye-drop form, beta blockers are sometimes used in the treatment of glaucoma. Perhaps the drug has been prescribed for one of these conditions?

I do suffer from panic attacks and this is why I started the tablets. But how can one drug work on such a wide range of problems?

Beta-blockers are a type of drug that works by blocking the transmission of stimuli through beta receptors found in the heart muscle, airways and blood vessels.

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The drug cancels the action of a chemical called noradrenalin which produces the "fight or flight" reaction often associated with panic disorder.

It reduces the rate and force of the heart beat, prevents blood vessels in the extremities from dilating and reduces air flow through the lungs.

Used for the treatment of migraine, the drug works on the blood vessels surrounding the brain to help prevent a migraine attack. In hypertension (high blood pressure) it works by lowering the rate and force at which the heart pumps blood. By slowing the heart beat it also helps prevent angina and abnormal heart rhythms.

When used in the treatment of glaucoma, beta-blocker eye drops work by reducing fluid production, which in turn lowers the pressure inside the eye.

I suffer from very cold hands and feet. Is this a side effect of the drug?

Beta-blockers cause a reduction in the blood flow to the extremities and this commonly causes the hands and feet and sometimes even the tip of the nose and ears to feel cold.

In addition, as a result of its effect on circulation, impotence may be a problem while taking the beta- blockers.

Because beta-blockers reduce heart rate and air flow to the lungs, some people notice a reduced capacity for exercise.

The drug is used with caution in those with respiratory diseases, such as bronchitis or asthma, those with poor circulation in their limbs, diabetics and people who suffer from heart failure.

The drug should not be stopped suddenly if used for a prolonged period, but rather it should be reduced slowly over time under medical supervision.

Marion Kerr