Originally Released: August, 1998
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A study of more than 200,000 heart attack patients finds that drugs called beta blockers improve two-year survival by 42 percent in almost all patients, no matter what their age, medical condition or heart function. University of Maryland Medical Center cardiologists who conducted the study say it demonstrates that these drugs are not just effective, but also safe, even for high-risk individuals. Results of the study are published in the August 20 issue of the New England Journal of Medicine.
"These findings should prompt all physicians to routinely prescribe beta blockers for their patients following a heart attack. Currently, only about one-third of the patients who could benefit from these drugs receive them," says Stephen S. Gottlieb, M.D., director of the Cardiac Care Unit at the University of Maryland Medical Center and the lead author of the study.
Dr. Gottlieb, who is also an associate professor at the University of Maryland School of Medicine, studied a database from the Health Care Financing Administration of 201,752 Medicare recipients who had a heart attack during 1994 or 1995.
Overall, 34 percent received beta blockers. After taking into account other factors that affect mortality, the researchers found that 14 percent of those in the beta blocker group died within two years, compared to 24 percent in the group that did not take the drug, a difference of about 42 percent. That translates into almost 20,000 people whose lives may have been saved by taking the medication.
Beta blockers are commonly prescribed for a variety of problems including high blood pressure, chest pain and arrhythmia. Dr. Gottlieb says many physicians are reluctant to give them to very elderly patients, those with diabetes, lung disease and other health problems, because of the fear of adverse side effects.
"However, every subgroup of patients that was treated with beta blockers after a heart attack experienced reduced mortality," says Dr. Gottlieb.
Beta blockers include metoprolol, atenolol and propranolol, and others. The drugs block the action of norepinephrine, or adrenaline, which the body produces under stress. The drugs reduce demand on the heart, slow the heart rate and prevent irregular heart beats.
The study was funded by a $60,000 grant from the Delmarva Foundation. Co-investigators included Robert Vogel, M.D., head of Cardiology at the University of Maryland Medical Center and Robert J. McCarter, Ph.D.
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