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Beta-Blocker Drugs Safely Treat Heart Failure
July 12, 2004 -- The benefits of treatment with beta-blockers outweigh the potential risks for people with heart failure, a new study shows.
The study shows that although there is a small risk of worsening symptoms initially beta-blocker therapy is generally safe for people with heart failure and use of these drugs can reduce the overall risk of death by 27%.
Researchers say beta-blocker therapy was once thought to be hazardous for people with certain types of heart failure. By slowing the heart and relaxing blood vessels they can cause side effects such as low blood pressure, dizziness, low heart rate, and fatigue. The effects of these drugs were thought to cause heart pumping function to deteriorate -- making the symptoms of heart failure worse.
Although individual studies have documented the risks associated with these adverse effects, researchers say no study has combined the available information to get the best estimates of these risks during treatment with beta-blockers among people with heart failure.
"Concerns about adverse effects may deter clinicians from prescribing this life-saving therapy," write researcher Dennis Ko, MD, of the University of Toronto, and colleagues. "This information should allow practitioners and patients to place the risks of beta-blocker therapy in the proper perspective."
Beta-blockers is a class of drugs that block substances that stimulate the heart, relieve stress on the heart, slow the heartbeat, and reduces the force with which the heart muscle and blood vessels contract against.
Beta-Blockers Safe for Treatment of Heart Failure
For the study, published in the July 12 issue of the Archives of Internal Medicine, researchers analyzed data from nine clinical trials of beta-blockers in nearly 15,000 heart failure patients. The studies had follow-up periods ranging from six to 24 months.
Researchers found use of beta-blockers in the treatment of heart failure was associate with a 27% decrease in death from any cause, which translated to an estimated 34 deaths prevented per 1,000 patients treated per year.
Treatment with beta-blockers was associated with small increases in the risk of low blood pressure (an increase of 11 cases per year per 1,000 patients treated), dizziness (57 per 1,000), and low heart rate (38 per 1,000).
But people treated with beta-blockers were also less likely to:
- Stop taking their medications (14 fewer cases per 1,000 patients treated per year)
- Be hospitalized for heart failure (40 per 1,000)
- Experience a worsening of their heart failure condition (52 per 1,000)
In an editorial the accompanies the study, Kanu Chatterjee, MB, of the Chatterjee Center for Cardiac Research at the University of California, San Francisco, says that doctors should discuss the potential side effects of beta-blockers with their patients.
"It should be emphasized that this initial deterioration of symptoms is quite common and should not be reason for discontinuation of beta-blocker therapy," writes Chatterjee. "The patient should understand that these symptoms will resolve and cardiac function and prognosis will improve with continued therapy."
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