Beta blockers have been the gold-standard prescription after a heart attack for decades. These drugs were supposed to reduce the risk of complications, help the heart work better and save lives.
Yet new ground-breaking research exposes a disturbing truth: They may not be helpful to most patients and could raise the risk of hospitalization or death in some women.
The results, in the European Heart Journal and simultaneously presented at the Congress of the European Society of Cardiology in Madrid, are changing the international guidelines on treatments.
What Are Beta Blockers, and Why Are They Prescribed After a Heart Attack?
Beta blockers: These drugs function by
Slowing the heart rate
Lowering blood pressure
Reducing the effects of adrenaline
Doctors generally use these drugs after a heart attack (myocardial infarction) to help avoid additional cardiac events. Beta blockers are still a known treatment for patients with weakened heart function (ejection fraction less than 40%).
But for those with normal heart function (50% higher) in the heart, recent studies put their benefits in doubt and throw out serious safety concerns for women.
A study is highlighting the potential risks of beta blockers among women following a heart attack, but researchers said more investigation was needed before any changes to current treatment recommendations could be made.
That Threat Is Even Greater for Women in Good Heart Health
According to the groundbreaking study, women with limited heart damage after a heart attack who were prescribed beta blockers were:
Much more likely to have a second heart attack
With an increased risk of heart failure hospitalization
Almost three times as likely to die compared to women who were not prescribed beta blockers
The risks were most pronounced among women who took the drug at higher doses.
No Benefit for Men Without Heart Failure
The researchers also found that men with normal heart function did not have increased risks from beta blockers. But equally, they derived no measurable benefit from the drug.
This raises the possibility that sex influences the way patients respond to these drugs after a heart attack.
Beta Blockers Help Even Those With Mildly Damaged Hearts
Even among patients who have completely normal pumping function (more than 50% ejection fraction) and thus may not have needed to be on beta blockers, a study in The Lancet discovered that patients with only mildly reduced heart function (40 to 50% pumping activity) got benefits.
These patients experienced about 25 percent fewer deaths, new heart attacks and heart failure when taking beta blockers.
Why Beta Blockers Have a Different Effect in Women
The findings are not entirely unexpected, medical experts say. Numerous factors account for why women react differently to beta blockers following heart attacks:
Women tend to have smaller hearts and could be more affected by blood-pressure drugs.”
Men and women Please how drugs are used by the body
In women, heart attacks often reflect the obstruction of plaque in small blood vessels, whereas men tend to have blockages in larger arteries
Symptoms vary by gender: men are more likely to complain of chest pain, whereas women may experience back pain, indigestion, or shortness of breath
Dr. Andrew Freeman, the director of cardiovascular prevention and wellness at National Jewish Health, said:
“Gender matters a lot in how people respond to medications. Some of it is about body size, she says, and some of it is about factors we don’t yet understand.”
The Trouble With Old Beta Blockers Advice
Even so, 80% of the world’s heart attack patients continue to receive beta blockers, on the basis of heart function or not.
“Without a doubt, this is one of the most important studies that we have ever done,” Dr. Valentin Fuster, the study’s senior author and president of Mount Sinai Fuster Heart Hospital, said.
“These results will change all the international clinical guidelines of beta-blockers in men and women, and will trigger a long-awaited sex-specific approach in the treatment of the disease.
The difficulty is in updating international medical guidelines so that they take into account male and female differences.
Every Day Normal Adverse Reactions of Beta Blockers
Beta blockers- Even when a positive beta blocker and side effects, such as, are known to cause loss of libido.
Low blood pressure
Slow heart rate
Fatigue
Mood swings
Erectile dysfunction
These side effects need to be weighed against any potential benefit for individual patients by their doctors.
What This Means for Patients With Heart Attacks?
The new research indicates for women whose hearts are functioning normally following a heart attack, beta blockers might do more harm than good. They are still a crucial therapy for patients with mild or even severe heart damage.
The bottom line is that treatment has to be personalized, not automatic. Whether beta blockers should be recommended to all heart attack patients is a separate issue, and one patients should discuss with their cardiologists.
Beta-blockers FAQ Heart attack Text: How we wrote the article The “beta-blockers after heart attacks” article was produced exclusively by STAT, independently and not as part of any collaboration with a division of the company.
What are beta blockers for after a heart attack?
Beta blockers slow down the heart, lower blood pressure and reduce the risk of future heart problems. They’ve been long-term standbys for decades, but a new study suggests that they may not help everyone at all.
Is it safe for women to take beta blockers after a heart attack?
Not always. The new research finds an increased risk of death and hospitalization among women who have normal heart function (ejection fraction over 50%) and are given a beta blocker. But even women with broken hearts may still benefit.
Should men remain on beta blockers after a heart attack?
Men with normal heart function get no proven benefits from beta blockers after heart attacks. However men with “soft” hearts (less than 40% ejection fraction) still derive significant benefit from these medications.
What is ejection fraction and why does it matter in beta blocker treatment?
Ejection fraction is a measure of how well your heart pumps blood. Normal is above 50%. Below 40% indicates significant damage. It is your “ejection fraction” that can help to establish whether beta blockers will be a benefit to you, or possibly harmful.
If I’m already on beta blockers, should I discontinue taking the medication?
Never discontinue beta blockers without consulting your doctor. Stopping suddenly can be dangerous. Ask your cardiologist instead, if your medication weeks well with your individual heart condition.
How will this new evidence alter guidelines for treating people with heart attacks?
We anticipate these findings will lead to changes in recommendations by medical societies around the world. Future treatment is likely to become more tailored according to sex, heart function, and individual risk factors rather than a one-size-fits-all method.
Final Thoughts
Significant change in cardiac care Beta blockers after heart attack: many studies already, brand new twist The Nobel Prize-winning discovery that nitric oxide is a signaling molecule in the cardiovascular system has had far reaching implications for health. The results emphasize that what is good for the goose isn’t necessarily good for the gander, and they raise the idea that you have to find a personalized treatment.”
Beta blockers put women with a healthy heart at grave risk: It is a side effect that was previously unknown. Meanwhile, patients with ailing hearts continue to receive the lifesaving drugs.
The bottom line for patients: don’t adjust your medications yourself. Partner with your cardiologist to develop a plan that suits your particular health, heart function and risk factors.
As medical recommendations adapt to accommodate these discoveries, we’re advancing toward a more customized approach to recovery after a heart attack — one that takes into account gender, heart function and various other patient factors rather than applying one-size-fits-all treatments.
