Beta Blockers Not Effective in All Heart Attack Patients

Beta blockers may be unnecessary for patients who experienced a heart attack and did not develop heart failure.

Prescribing beta blockers for patients who experienced a heart attack is common practice among physicians; however, findings from a new study published by the Journal of the American College of Cardiology challenges this prescribing habit.

In the study, the authors examined patients who experienced a heart attack but did not develop heart failure, which is a complication of a heart attack if the muscle was damaged.

The authors discovered that patients who did not develop heart failure after a heart attack did not have extended life while on beta blockers, despite 95% of patients being prescribed the drugs. If these results are confirmed, the study suggests that there is significant waste occurring.

Beta blockers reduce the activity of the heart and lower blood pressure, which can result in dizziness and tiredness in some patients, which can impact quality of life.

Patients who experienced a heart attack and developed heart failure must take beta blockers to ensure that their heart is working efficiently, but not all patients develop heart failure.

Included in the study were data from 179,000 patients who experienced a heart attack without heart failure. The authors aimed to determine if beta blockers affect lifespan for patients after heart attack if they did not have heart failure.

When the authors compared mortality rates within 1 year of the heart attack, there was no statistical difference among patients who had been prescribed the drugs compared with those who had not, according to the study.

"If you look at the patients who had a heart attack but not heart failure -- there was no difference in survival rates between those who had been prescribed beta blockers and those that had not,” said lead investigator Marlous Hall, PhD. "This was an observational study based on robust statistical analysis of large scale patient data. What we need now is a randomized [sic] patient trial. We were investigating one outcome -- did beta blockers increase a patient's chances of survival? A trial would allow researchers to substantiate these findings and also look at other outcomes, such as whether beta blockers prevent future heart attacks. This work would have implications for personalising [sic] medications after a heart attack."

The study suggests that it is possible that beta blockers are being overprescribed to patients who have experienced a heart attack.

The authors state that additional studies are needed to further understand the risks and benefits of beta blockers for patients who experienced a heart attack and did not develop heart failure.

"There is uncertainty in the evidence as to the benefit of beta-blockers for patients with heart attack and who do not have heart failure,” said Chris Gale, PhD, Professor of Cardiovascular Medicine at the University of Leeds and Consultant Cardiologist at York Teaching Hospital Trust. “This study suggests that there may be no mortality advantage associated with the prescription of beta-blockers for patients with heart attack and no heart failure. A necessary next step is the investigation of beta-blockers in this population in a randomised [sic] controlled trial."