Questioning the benefit of beta blockers in treating heart failure

Related articles

In 2010, nearly 200 million scripts for beta blockers a class of drugs used to treat hypertension, heart failure, angina, and abnormal heart rhythms were filled in the U.S., making them the fourth-most commonly prescribed therapeutic class. Currently, the treatment remains the standard of care for most patients with coronary artery disease (CAD). But new research published in the Journal of the American Medical Association finds that beta blockers may not, in fact, reduce the risk of heart attack, stroke or death in these patients.

For the study, researchers from the New York University School of Medicine analyzed data on nearly 45,000 patients who had either previously suffered a heart attack, were diagnosed with CAD but had no prior heart attack, or were simply at greater risk of CAD. After a nearly 4-year follow-up, the results showed that there was no significant difference in the incidence of heart attack, stroke or death in patients taking beta blockers, compared to those who did not. In fact, among patients who were at high risk of CAD, those on beta blockers actually had a slightly increased risk of an adverse cardiovascular event than those who were not taking the drug.

The findings are quite startling, especially since the use of beta blockers to treat CAD has been written in stone for quite some time. When I first entered practice in the 1970s, says ACSH s Dr. Gilbert Ross, beta blockers were never used to treat patients with heart failure. Yet slowly but surely, studies began demonstrating their efficacy, and over the next decade, they became the standard of care. The latest study, however, shows that beta blockers are not as beneficial as we thought, which leads me to believe that these drugs may no longer have a major role in the management of heart disease. At the least, these new data indicate that patients with history of or risk factors for cardiovascular disease should not be routinely put on these medications.