Research Suggests Beta-Blockers are Prescribed Excessively

The Guardian newspaper has reported that beta-blockers may be over prescribed.

Picking up on a study which examined the commonly used medicine, the publication noted that “many patients given beta-blockers after a heart attack may not benefit from being on the drugs”.

Beta-blockers are used to regulate the heart by making it beat more slowly and with less force.

They are most frequently prescribed for those to be facing the risk of heart failure.

Yet the new study involving English and Welsh scientists also found that beta-blockers had minimal health impacts on a cohort of 170,000 patients.

The study compared mortality rates between those who were prescribed beta-blockers and those who weren’t when they were discharged from hospital.

Though there were fewer deaths one year later among people prescribed beta-blockers (5% vs. 11%), the researchers concluded that beta-blockers did not affect risk of death once other risk factors and medications were taken into consideration.

The study was carried out by researchers from multiple UK institutions including the University of Leeds, University of Edinburgh, University College London, Bart’s Heart Centre London and York Teaching Hospital NHS Foundation Trust as well as institutions in Sweden, France and Spain.

It was funded by the British Heart Foundation, and has been published in the peer-reviewed Journal of the American College of Cardiology on an open-access basis, meaning it is freely available online.

The prospective cohort study involved 179,810 people who were hospitalised following a heart attack in the UK between 2007 and 2013.

They were identified using the national heart attack register in the UK – known as MINAP (Myocardial Ischaemia National Audit Project).

Beta-blocker use was determined by looking at people who had received a beta-blocker prescription on discharge from hospital.

Analyses were carried out and then adjusted for the following confounders:

– sex
– socioeconomic deprivation
– year of hospital admission
– cardiovascular risk factors
– chronic obstructive pulmonary disease
– stroke
– peripheral vascular disease

Of the 179,810 people who survived a heart attack during this period, 9,373 died within a year of their initial hospitalisation.

There was no difference in effect depending on whether or not people had a heart attack with the classical heart attack features on electrocardiogram (ECG, showing elevation of the ST segment).

The researchers conclude that “among survivors of hospitalization with heart attack who did not have heart failure or left ventricular systolic dysfunction as recorded in the hospital, the use of beta-blockers was not associated with a lower risk of death at any time point up to 1 year.”

While the study provides some interesting data, it is not yet possible to conclude whether they should have any impact on treatment going forward.

 

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