Beta-Blockers — Still the Best?

A study questions beta-blocker results

Beta-blockers have been a go-to medication for patients with heart disease for years. But new research questions whether these drugs actually prevent future heart attack, stroke or cardiovascular death.

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When should beta-blockers be prescribed? And, which patients really benefit?

These questions have surfaced thanks to a study released in the Journal of the American Medical Association (JAMA) that looked at nearly 45,000 patients with prior heart attacks, coronary artery disease or risk factors. Those on beta-blockers—medications that stop adrenaline receptors in the brain that are activated under stress—didn’t show significantly lower rates of heart attack, stroke or cardiac death.

But these results do not mean beta-blockers are out.

Beta-blockers are still the standard

This study is not enough to stop doctors from prescribing beta-blockers. A new, randomized, controlled study will be necessary before any real conclusions can be drawn.

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“Abandonment of this type of therapy for post-MI [heart attack] patients based upon an observational study is not warranted,” says Steven Nissen, MD, chair of the department of cardiovascular medicine at Cleveland Clinic.

However, the study could prompt doctors to think harder about which patients get beta-blockers. Dr. Nissen says beta-blockers are not a good option for hypertension. But, they should be prescribed for patients post-heart attack. “We should not change the [post-heart attack] American Heart Association guidelines based on this type of analysis when randomized controlled trials (RCTs) have consistently shown benefits [to taking beta-blockers],” Dr. Nissen says.

What next?

Patients can talk to their doctors about beta-blockers and ask whether the dosing or alternatives should be considered. No one should stop taking the medications because of this study—they are still an effective, proven medication for patients post-heart attack.

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