Propranolol belongs to a group of medicines called beta-blockers, which block beta receptors in the heart, lungs and other organs of the body. Blocking these receptors prevents the action of two chemicals called noradrenaline and adrenaline that occur naturally in the body. These are often referred to as the 'fight or flight' chemicals as they are responsible for the body's reaction to stressful situations.
Blocking the beta receptors in the heart causes the heart to beat more slowly and with less force. The heart therefore uses less energy and the pain of angina is prevented. Slowing the heart also helps control abnormal heart rhythms (arrhythmias), which can seriously undermine the pumping action of the heart and result in inefficient blood circulation around the body.
Due to the heart beating more slowly and with less force, the pressure at which blood is pumped out of the heart to the rest of the body is reduced. This is just one of the ways in which beta blockers help to reduce blood pressure, however the whole mechanism is not fully understood.
Side effects include fatigue, dizziness, nightmares and cold extremities, eg hands and feet.
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