Heart failure patients who undergo beta-blocker therapy tolerated the treatment well and had less heart failure deterioration than placebo drugs, researchers at Yale School of Medicine and other institutions report 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," said senior author Harlan M. Krumholz, M.D., professor of internal medicine and cardiology at Yale 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 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 percent relative reduction in mortality. They also found that adverse effects of beta-blockers were low compared to control, which they said 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 said 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," said Krumholz, who is also an attending cardiologist and director of the CORE Program at Yale-New Haven Hospital.
Other authors on the study included first author Dennis T. Ko, M.D., of the University of Toronto; Patricia R. Hebert, Jeptha P. Curtis, M.D., and JoAnne M. Foody, M.D., of Yale School of Medicine; Christopher S. Coffey of the University of Alabama at Birmingham; and Artyom Sedrakyan, M.D., of the Royal College of Surgeons, London, England.
Citation: Archives of Internal Medicine, Vol. 164, July 12, 2004.
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