Heart failure patients who undergo beta-blocker therapy tolerated the treatment well and had less heart failure deterioration than placebo drugs, researchers at Yale and other institutions reported in the July 12 issue of Archives of Internal Medicine.
"Beta-blocker drugs not only save the lives of patients with chronic heart failure, but patients are less likely to stop taking these medications than the placebo, indicating how well-tolerated they are," says senior author Dr. Harlan M. Krumholz, professor of internal medicine and cardiology at the School of Medicine. "This study is meant to address the concerns on the part of the medical community, that beta-blockers may cause adverse effects in this population."
Beta-blockers are any of a group of drugs widely used in the treatment of patients with heart disease and hypertension. The drugs decrease the rate and force of heart contraction by blocking the beta-adrenergic receptors of the autonomic nervous system.
Krumholz and his colleagues reviewed data from nine randomized trials comparing beta-blockers with placebo in heart failure patients in order to measure the risks of adverse effects. They found a 27% relative reduction in mortality for those using the drugs. They also found that adverse effects of beta-blockers were low compared to control, which they say should alleviate concerns about beta-blocker risk factors.
Concerns among physicians that beta-blockers are associated with side effects may have kept some from prescribing the therapy, but Krumholz says this should not deter physicians from using this effective class of medications.
"While it is true that beta-blocker therapy is associated with some side-effects, such as hypotension-low blood pressure, dizziness and slow heart beat, the increases in risks are small, and fewer patients stopped taking beta-blocker therapy due to side effects than from placebo," says Krumholz.
Other authors on the study included first author Dr. Dennis T. Ko of the University of Toronto; Patricia R. Hebert, Dr. Jeptha P. Curtis and Dr. JoAnne M. Foody of the Yale School of Medicine; Christopher S. Coffey of the University of Alabama at Birmingham; and Dr. Artyom Sedrakyan of the Royal College of Surgeons, London, England.
-- By Karen Peart
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