Some Heart Attack Patients Might Not Need Beta-Blockers

Fact checked by Nick Blackmer

Key Takeaways

• New research suggests that, for those who have had a heart attack and who have not sustained significant damage, beta-blockers may be unnecessary.

• Experts say this doesn’t mean patients should immediately stop using beta-blockers.

• More research is needed to confirm these results.

A new study found that beta-blockers may not be necessary for some patients who have had a heart attack.

Beta-blockers are medications that reduce the stress on the heart. They’ve been used for heart attack patients since the 1980s, a time when there were fewer options for detection and treatments.

The study, published in the New England Journal of Medicine, recruited 5,020 participants, mostly in Sweden. The participants had a heart attack but maintained significant heart function. Researchers found that those who were given beta-blockers didn’t show much better health outcomes than those who weren’t given the medications.

Eric Elgin, MD, chief of the cardiology division at the Heart and Vascular Institute of Lehigh Valley Health Network, said this study is a good reminder for healthcare providers that continuous improvement requires interrogating long-held practices of the past.

“The study showed that in patients with a heart attack that also have preserved heart muscle function, there was no additional benefit to using beta blockers,” Elgin told Verywell. “This is huge, as it allows physicians to focus on the medications and treatments that continue to show benefits for patients.”

The new study only included people who had no significant damage to their hearts and had undergone early intervention. For those with more serious symptoms, beta-blockers appear to be a vital part of their care still, and more research needs to be done in both cases.

Related: Long-Term Beta-Blocker Use May Not Benefit Certain Patients, Studies Find

Could You Stop Taking Beta-Blockers?

There’s no indication that patients who have had a heart attack and were given beta-blockers should consider changing their dosage or usage right now.

“If you’re on a beta blocker, you don’t stop taking it—you need to taper off of it,” said Rennolds Ostrom, PhD, dean and a professor at Chapman University’s School of Pharmacy. “So it’s important for patients to consult with their healthcare providers in considering cessation of any drug, particularly drugs that affect the heart.”

Further research is needed for patients who have less heart function, said Andrew Paul DeFilippis, MD, MSc, medical director of the cardiovascular intensive care unit at Vanderbilt University Medical Center.

Heart function is determined by the portion of blood that leaves a ventricle when the heart pumps. The participants in the study had 50% or more ventricular ejection fraction.

“Subsequent research would be to confirm those results in a different patient population, with a different set of investigators, and then to start dialing down those strict criteria because this only affects a small portion of heart attack patients,” DeFilippis said. “But what if we dial back that number to 40%? How would that look?”

Related: How Beta Blockers Affect Your Target Heart Rate

Will This Research Change Treatment Guidelines?

More than 95% of participants in the new study were Swedish, and more than 75% were men. Ostrom said that while many of the findings are likely to be transferable to other patient populations in other parts of the world, more work needs to be done in order to consider how sex and race demographics could shift these results.

DeFilippis added that beta-blockers are relatively safe, but even with a small side effect profile, the drugs could affect a person’s quality of life, particularly when many medications are being combined. Some side effects of beta-blockers may include fatigue, depression, and headache.

“Our goal is not just to make patients live longer, but to live better. And sometimes, beta-blockers can have those side effects that are morbid for patients,” DeFilippis said.

As for whether new research will change how providers prescribe beta-blockers, Ostrom said further research needs to be completed for the findings to be implemented.

“Clinical practice sometimes changes slowly,” Ostrom said. “The reliance on beta-blockers in the cardiology world is very long and deep, So moving away from them in the proper patient profile is appropriate, but not necessarily going to happen at the speed as is probably needed.”

Read Next: Do Beta-Blockers Work for Anxiety?

What This Means For You

Research shows that beta-blockers may be unnecessary for heart attack patients, especially in those who have maintained significant heart function. However, more research in diverse populations needs to be conducted to confirm these findings.

Read the original article on Verywell Health.