Heart Attack Survivors May Safely Stop Beta-Blockers After One Year: Study

0:00Hi, I'm Helen Billings with The Epic Times, one of America's largest independent newspapers. Today we've got a new study that could have some pretty big implications for heart attack survivors who are on beta blockers. These medications are usually meant to be taken permanently after a heart attack. But this study shows us that might not be the case after all. Stay tuned as we discuss. But first, want to help shape the future of The Epic Times podcast network? Check out our survey link in the show notes to learn how. Okay, so for some basic background, beta blockers are one of the most common medications for people who've suffered heart attacks. What they do is that they slow your body's heart rate and blood pressure by blocking adrenaline and other hormones. And right now, the current guidelines recommend that a person should stay on them permanently after having a heart attack. But today's study might suggest otherwise is a pretty major study published last month in the New England Journal of Medicine. Here's how it was done. The researchers

1:02tracked a group of 2,540 heart attack survivors from across South Korea. They had all been on beta blockers for at least one year after suffering the heart attack and they hadn't had another incident since. The patients were told to either stop or continue using beta blockers. And the researchers tracked the results over an average of 3.5 years. They were looking for three things, death from any cause, another heart attack, or hospitalization for heart failure. At the end of the study, they found that the group who stopped using the beta blockers actually had a lower percentage of these outcomes. It was 7.2% for those who stopped, versus 9% for those who continued. So because the mortality rate was lower for those who stopped taking the medication, the researchers concluded that, quote, stopping beta blockers was not worse than continuing them for major outcomes, unquote. Now, that's pretty significant for a number of reasons. And it could have a big impact on the future of treatment, post

2:03heart attack. So we'll cover that now. So to summarize, the study found that going off beta blockers over a year after a heart attack does not increase a person's risk of having another one, or from dying of other heart-related diseases. And like we mentioned right now, surviving a heart attack can mean lifelong treatment with beta blockers, as is the case with millions of Americans. So with that being said, the results from the study could be huge, especially with more research. We reached out to experts from the cardiology community to see what they think. Dr. Peter Coey is a cardiologist at the Lankanow Institute for Medical Research and a professor of medicine at Thomas Jefferson University. Here's what he told us, quote, I am sure that guideline committees around the world will be reshaping the recommendations in light of the new evidence about when to start and when to stop beta blockers, unquote. And when speaking of when to stop, Dr. Jo Young Han from South Korea gave us his

3:04input as well. He's a senior author of the study. As a cardiologist at the Sam Song Medical Center, he says that many stable patients stay on beta blockers for years, despite quote, potential adverse effects and medication burden, unquote. And in a day and age when secondary prevention measures are strong, Dr. Han told us we expected that continuing beta blockers indefinitely might offer limited additional benefit. Still, Dr. Han and Dr. Coey agreed on one thing, that it's essential to take an individualized approach with each patient and to keep monitoring their health, even if they decide to stop beta blockers. So let's talk a little more about that. But first, the Epic Times podcast network is evolving and we would like your help in shaping our future. By filling in our short online survey at www.tinyurl.com slash ET podcast survey, you can help us learn how to best move forward.

4:05So when might it be appropriate for a heart attack survivor to get off beta blockers? Dr. Han says the best candidates are patients who are mostly healthy. That would mean having no heart failure and no side effects from the medication. And also, patients should not have a condition called left ventricular systolic dysfunction, which can be a serious issue with heart pumping. Dr. Coey told us something similar. He said that we shouldn't lose side of the significant benefit of beta blockers for those who need them, especially for patients with significant left ventricular dysfunction or cardiac arrhythmias. But for healthier patients who are considering stopping, there's a few simple but critical things to keep in mind. Here's what we gathered from Dr. Carolyn Lamb. She's a cardiologist and co-founder of an AI powered imaging company called US2.AI. First, patients should only stop with the guidance of a medical professional. And even then, Dr. Lamb says it should be a gradual tapering off.

5:05During this process, both Dr. Lamb and Dr. Han agreed that it's essential to monitor some basics, things like heart rate and blood pressure. Dr. Han did mention that these increased modestly for the patients in the study. But of course, if they get too high or if there's newer worsening symptoms like angina or arrhythmias, Dr. Lamb says we do not hesitate to restart or adjust therapy. And it's important to follow up with a clinician too, since they can do scans and check for things like blood velocity or volume, which are harder to check at home. Before we wrap up today's episode, we should mention a few important things that might have limited the study. For one, the study was only done in South Korea. And besides that, there was an under-representation of women in patients with mildly reduced heart function. And very importantly, most of the participants had been taking beta blockers for several years already before stopping. So we cannot be sure if the results apply to patients who have

6:05been taking them for a shorter time or how soon after a heart attack it's safe to stop. One last note, it's very important to remember that the participants in the study were quote, stable post-heart attack patients without heart failure or weakened pumping function. So patients with complications should keep that in mind. But overall, the study is major research that may give a whole new outlook for people who've survived heart attacks, especially for the hope that beta blockers don't have to be something that has taken life long. Well, thanks for listening to our report. If you'd like to read it in detail, the link is in the notes. A final reminder, we're working to make the Epic Times podcast network even more useful and enjoyable for you. Your perspective would be incredibly helpful in guiding those changes. If you're willing, please take our quick survey at www.tinyurl.com slash ET podcast survey. It only takes a minute or two. Further details are available in the show notes. Thank you. This is Helen

7:08Billings with the Epic Times. Remember to be patient with your journey and take care of yourselves. Until next time.