FOR IMMEDIATE RELEASE: March 11, 2002
Contact: Bill Seiler bseiler@umm.edu 410-328-8919
Ellen Beth Levitt eblevitt@umm.edu 410-328-8919

UNIVERSITY OF MARYLAND RESEARCHERS CONCLUDE BETA-BLOCKERS ARE SAFE FOR PATIENTS WITH HEART FAILURE

An analysis of the largest study of beta-blockers to treat congestive heart failure shows that these medications can be used safely for patients with mild to moderate heart failure. The report, by researchers at the University of Maryland School of Medicine in Baltimore, is the first to analyze what happens to patients in the first 90 days after administration of the drugs, and puts to rest concerns that beta-blocker therapy worsens heart failure when the therapy is initiated.

The study appears in the March 12 issue of Circulation: Journal of the American Heart Association.

Stephen S. Gottlieb, M.D., cardiologist at the University of Maryland Medical Center, and lead author of the study, says beta-blockers have recently been proven to increase survival, reduce hospitalizations for heart failure and improve the heart's pumping function when given over a long period of time. "Improvement in cardiac function occurs after patients have been on beta-blockers for about a month," says Dr. Gottlieb, who is also a professor of medicine at the University of Maryland School of Medicine. However, some physicians have been concerned that many heart failure patients might not tolerate these drugs and have been reluctant to give them to patients.

The study collected data on nearly 4,000 patients with mild to moderate heart failure, who were volunteers in the Metaprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF). Researchers studied the controlled-release/extended-release formulation of the beta-blocker metoprolol succinate.

Patients in the study were started at very low doses, which were gradually increased. Patients with mild heart failure received an initial dose of 25 milligrams (mg) or a placebo, while patients with moderate heart failure received 12.5 mg or a placebo. The dose was doubled after each two-week period until the target daily dose of 200 mg was achieved.

Investigators monitored side effects, taking into account such factors as worsening symptoms, adverse events and adjustments in medication. They found that side effects were extremely rare, but that improvement did not occur immediately. Dr. Gottlieb says, "Our study supports the need to watch these patients carefully while they are gradually given higher doses to eventually meet the target dose."

Dr. Gottlieb is a co-author on another beta-blocker study appearing today in the Web version of Circulation. That study concludes beta-blockers benefit women as much as men. That study also drew data from the MERIT-HF trial and two other large studies. It found that women who took the beta-blocker metoprolol CR/XL lived longer and were hospitalized less often than women who were not on the drugs.

Both studies were funded by grants from AstraZeneca.

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