Common Heart Drug May Block Atherosclerosis
All participants had ultrasound studies of their carotid arteries before enrollment in the study, and at 18 months and three years after starting treatment. Ultrasound is an imaging technique that allows a detailed assessment of the artery. It can pick up thickening of the artery wall, which is indicative of atherosclerosis.
The benefit of metoprolol was evident at 18 months. Metoprolol slowed the progression of atherosclerosis by about 40%. The participants taking metoprolol also tended to have fewer strokes and heart attacks during this time.
"It is very interesting but not unexpected that metoprolol was found to slow down atherosclerosis in the carotid artery, which is an artery where this disease process is common," Björn Fagerberg, MD, PhD, tells WebMD.
Fagerberg, who was not involved in the study, explains that metoprolol decreases death rate in patients with heart attack, high blood pressure, and heart failure. Animal experiments also have indicated that metoprolol helps reverse the effects of atherosclerosis. Fagerberg is a professor of medicine at Sahlgrenska University Hospital in Göteborg, Sweden
In Berglund's study, the group taking fluvastatin had a 75% reduction in progression of carotid artery wall thickening. As fluvastatin and metoprolol seemed to work at different sites along the carotid artery, they might be used together for greater effect to prevent heart disease and strokes, Berglund suggests.
Beta-blockers such as metoprolol also may work directly on the brain to reduce stress, Berglund explains, which possibly plays an important role in aggravating atherosclerosis.
Metoprolol's effect on lowering blood pressure might be another mechanism that slows development of atherosclerosis, explains Toshifumi Mannami, MD, a cardiologist at the National Cardiovascular Center in Japan.
"Our results from our laboratory were that there are strong and significant relationships between carotid [wall] thickening and blood pressure," says Mannami, who was not involved in Berglund's study.
"The study provides new information that will help us to better understand the underlying disease processes," Fagerberg says. "Further studies are needed to confirm the results and to establish how they should be applied to treatment of the individual patient."