The use of beta blockers to prevent a second heart attack is called into question by researchers today.
The evidence is unclear on the benefit for patients who survived their heart attack without developing heart failure or left ventricular systolic dysfunction, especially after the first year, according to Swedish researchers.
Dr Gorav Batra of Uppsala University, Sweden, and his team carried out a nationwide study including 43,618 male and female patients diagnosed with heart attack between 2005 and 2016. Of the patients, 79% were prescribed beta blockers.
Outcomes were better for those prescribed beta blockers, but once several other factors were taken into account the benefit disappeared.
In BMJ Heart today, the authors write: “Evidence from this nationwide cohort study suggests that beta blocker treatment beyond one year of myocardial infarction for patients without heart failure or left ventricular systolic dysfunction was not associated with improved cardiovascular outcomes.”
Commenting in an editorial, Professor Ralph Stewart and Dr Tom Evans, of Green Lane Cardiovascular Services, Auckland, New Zealand, write: è¿ecommendations on the duration of beta blocker therapy are variable or absent because this question was not specifically evaluated in clinical trials.
å…¸his study raises an important question directly relevant to the quality of care – do patients with a normal functioning heart benefit from long term beta-blocker therapy after heart attack?”
They call for more evidence from large randomised clinical trials in order to answer this question.
Ishak, D. et al. Association of beta-blockers beyond 1 year after myocardial infarction and cardiovascular outcomes. BMJ Heart 3 May 2023; doi: 10.1136/heartjnl-2022-322115
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