A heart attack occurs when blood flow to a part of the heart muscle is blocked, usually by a blood clot in a coronary artery. While some people survive (if they are given prompt first aid assistance), many succumb to the condition. Treatment is usually focused on restoring blood flow, limiting heart damage, and preventing future events. Medicines work towards breaking up clots, thinning the blood, reducing chest pain, and improving blood flow to the heart.
But while medications play a crucial role in treating heart attacks and preventing future episodes, a new study highlights the risk of one common heart attack treatment drug for women, suggesting that it might even raise the risk of death.
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What Has Study Found?
A growing body of research is questioning whether beta-blockers, long considered a cornerstone of treatment after a heart attack, are equally effective for women. While these drugs are prescribed to reduce strain on the heart and lower the risk of another cardiac event, new evidence suggests they may not always offer the same level of protection for women as they do for men—and in some cases, they could even increase the risk of death or another heart attack.
A new study published in the European Heart Journal, also scheduled to be presented Saturday at the European Society of Cardiology Congress in Madrid, found a possible increased risk of death among women taking beta blockers, though the numbers were relatively small and need to be interpreted with caution.
“This was especially true for women receiving high doses of beta-blockers,” said lead study author Dr Borja Ibáñez, scientific director for Madrid’s National Center for Cardiovascular Investigation.
“The total number of women in the clinical trial was the largest ever included in a study testing beta-blockers after myocardial infarction (heart attack), so this is a significant finding,” said Ibáñez, a cardiologist at Madrid’s Jiménez Díaz Foundation University Hospital.
The study was a sub-analysis of another larger trial published in the New England Journal of Medicine, in which researchers found that beta-blockers may not provide any significant benefit for certain heart attack patients.
Traditionally, beta-blockers have been prescribed after a heart attack to reduce the risk of death, repeat heart attacks, and heart failure. However, these recommendations were based on older trials conducted before modern treatments like routine angioplasty, stenting, and advanced medications became standard.
"These findings will reshape all international clinical guidelines on the use of beta-blockers in men and women and should spark a long-needed, sex-specific approach to treatment for cardiovascular disease," senior study author Dr Valentin Fuster, president of Mount Sinai Fuster Heart Hospital in New York City and general director of the National Center for Cardiovascular Investigation in Madrid, said as quoted in the report.
How Do Beta Blockers Work?
Beta-blockers work by blocking your body's stress hormones, adrenaline and noradrenaline, from binding to beta-receptors in the heart and other organs. This prevents the heart from racing, strengthens its beat less forcefully, and relaxes blood vessels and arteries, leading to lower blood pressure and less strain on the heart.
They are used for conditions like high blood pressure, irregular heart rhythms, heart failure, and anxiety, though they also block beta-2 receptors in the lungs and other areas, which can affect them too.
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Doctor's Reaction To The Study
In an interaction with the OnlyMyHealth team, Dr Rajendra Patil, Consultant Cardiologist, Jupiter Hospital, Pune, said, “This study makes it quite clear that in women with an ejection fraction of more than 50%, yes, there is a risk. But in women with an ejection fraction of less than 50%, where the heart’s pumping function is already impaired, there is definitely a mortality risk associated with the use of beta blockers.”
He added that the indications for starting beta blockers are very clear. “They are prescribed to control ischaemia and to manage arrhythmia.”
According to the doctor, for the majority of patients, beta blockers are beneficial. However, since this study specifically points to women with an ejection fraction above 50% and does not mention whether ischaemia was present. “The context is important,” he emphasised. If ischaemia is the reason for prescribing, then beta blockers will still provide benefit. Without ischaemia, however, beta blockers are not the first line of treatment,” he shared further.
Should People Be Concerned?
Dr Patil said, “I don’t think people should be overly concerned. Beta blockers are generally prescribed when indicated, and those indications apply broadly. If a patient does not have signs or indications such as ischaemia or arrhythmia, then beta blockers are anyway not the first choice of treatment. Otherwise, in the right patients, beta blockers are comparatively very safe.”