A new study suggests that low dose beta-blockers may be as effective as high dose after a heart attack. Surprisingly, heart attack patients live as long or even longer on one-fourth the suggested dose.
In a surprising new finding, heart attack patients treated with a substantially lower dosage of beta-blockers than used in earlier clinical trials, survived at the same rate, or even better, than patients on the higher doses used in those trials.
In fact, patients who received one-fourth of the original clinical trial dose had up to a 20 to 25 percent decrease in mortality compared to the full dose group.
About 90 percent of patients who have had a heart attack currently receive beta-blockers, a class of drug commonly prescribed to improve survival and prevent future heart attacks.
Beta-blockers block the effects of adrenaline on the heart, reduce irregular heartbeat and help prevent heart failure.
Lead investigator Dr. Jeffrey Goldberger launched the study that examined data in a multicenter registry on 6,682 patients who had a heart attack. About 90 percent were receiving beta-blockers. All the patients on beta-blockers survived longer than those who did not receive the drugs.
The data showed that of the people who received the full dose, 14.7 percent died within two years; of those receiving the half dose, 12.9 percent died; for the quarter dose, 9.5 percent died and for the one-eighth dose, 11.5 percent died.
Patients are treated with lower doses for a variety of reasons. There may be concern about possible side effects that may include fatigue, sexual dysfunction and depression.
In addition, when patients are started on conservative, low doses in the hospital after a heart attack, they return home so quickly, there is little time to adjust the dosage.
There is probably not one right dose for every single patient.
New research should be conducted to determine the most appropriate beta-blocker dose for individual patients to get the optimal benefit.
Dosage should be tailored to the needs of individual patients.
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