Beta blockers for life? Research illuminates 2023
Beta-blockers have long been used to treat cardiac disease and excessive blood pressure after a heart attack. A recent study found that long-term use of the medicine after a heart attack did not enhance cardiovascular health or lower the risk of future heart attacks, except for patients with heart failure or arrhythmia. Heart journaled the findings.
Beta-blockers do what? They reduce heart rate and inhibit stress chemicals. The sympathetic nervous system produces adrenaline and norepinephrine, which increase heart rate in stressful situations. Beta-blockers protect tissue against these hormones.
Researchers examined the medical data of persons who had a heart attack between 2005 and 2016 and needed hospital care using the Swedish national coronary heart disease register. 43,618 people, average age 64, were studied. 25% were women.
None suffered heart failure or LVSD. One year after heart attack hospitalization, 34,253 (78%) participants were taking beta-blockers and 9,365 (22%) were not.
Beta blockers save lives in heart failure, angina, and arrhythmia.
Researchers tracked rates of mortality, heart attacks, re-vascularization, and heart failure. Beta-blockers caused 6,475 (19%) of these incidents during surveillance. After controlling for demographics and co-morbidities, the researchers found no significant difference in rates between the two groups.
Real-time data indicated that long-term beta-blocker treatment did not enhance cardiovascular outcomes after a heart attack in persons without heart failure or left ventricular systolic dysfunction.
Dr. Balbir Singh, Chairman, Cardiac Sciences, Cardiology, Cardiac, Electrophysiology-Pacemaker, Max Hospitals, comments on the latest beta blocker study: “The study really doesn’t say anything new as cardiologists world over have been practising discretion when it comes to recommending beta blockers, which let me tell you is magical for heart failure. The study explains their selected and graded usage and if patients with normal cardiac function require it.
I never prescribe beta blockers for hypertension until a patient has tachycardia or a resting heart rate of more than 100 beats per minute.
Beta-blockers cannot prevent heart attacks. They save lives in heart failure, left ventricular systolic dysfunction, angina, and arrhythmia, thus you cannot discontinue them. The study shouldn’t suggest they’re terrible medications. He claims that verifies what we’ve been doing.
Interpreting findings requires discretion. Dr. Sunil Dwivedi, leading cardiologist at Manipal Hospitals, Bengaluru, says, “First of all this is just an observational study. To apply this sort of analysis in clinical practice, we need randomised studies to determine whether beta-blockers should be kept or terminated after one year post-myocardial infarction.
Beta blockers should be used for three years, except for heart weakness.
He claims the study validates treatment regimen. “Our old literature recommends beta blockers for three years and discontinuation except for heart weakness, heart failure, rhythm disturbances, and other compelling reasons. Only this study shortened weaning to a year. Dr. Dwivedi says the suggestion was identical.
Beta blockers improve angina symptoms and hospitalizations in people with CAD who have not had bypass surgery or stenting. If they have been re-vascularized (stents or bypass surgery) or have normal left ventricular function, beta blockers can be progressively weaned off, especially if they experience major adverse effects like weariness. Beta blockers prevent heart failure-related arrhythmia and mortality.
This study suggests that long-term beta-blocker use after myocardial infarction may not help people without complex risk factors and normal cardiac function. Early post-MI benefits are greatest. Long-term usage in normal heart function individuals may not benefit. He concludes, “Because cardiologists have been making a conscious decision on this anyway, these drugs retain the same value as before the study.”
