Good morning,

Beta blockers are everywhere. More than 26 million Americans take them for blood pressure, heart rhythm, and heart attack recovery. Some even use them for stage fright. They can be lifesaving for weak hearts. But for many others, the benefits are unclear and the side effects all too real.

Fatigue, weight gain, erectile dysfunction, and higher blood sugar are among the costs patients rarely hear about. In a recent article, I noted trials showing little benefit for heart-attack survivors with normal heart function. Women, meanwhile, faced higher risks of repeat events or hospitalization. Still, more than 80 percent of patients leave the hospital with a prescription, and most keep taking the pills for years.

That’s where deprescribing comes in. A yearly “medication reconciliation”—a simple review of what you’re taking and why—can reveal drugs you may not need anymore. Cardiologist Andrew Freeman says his favorite clinic days are when patients who’ve made lifestyle changes ask if it’s time to cut back. Often, the answer is yes.

The best alternatives aren’t more prescriptions—they’re daily habits. Walking, better sleep, stress relief, sunlight, and a diet rich in whole foods all lower blood pressure and strengthen the heart. Supplements like magnesium, CoQ10, and omega-3s can help too, but they work best as part of those bigger lifestyle changes.

Medications have their place, but they don’t always have to be lifelong companions. Movement, rest, nourishment, and calm are foundations that protect the heart, whether or not medicine is part of the plan.

Wishing you a healthy body and mind,

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Going Off Blood Pressure Meds Linked to Better Cognition

A study of nursing home residents found that deprescribing blood pressure medications was linked to slower cognitive decline, especially in those with dementia, raising questions about how aggressively older adults should be treated.

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