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

Hi, 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

tracked 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

heart 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

input 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.

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So 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.

During 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

been 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

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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

Billings with the Epic Times. Remember to be patient with your journey and take

care of yourselves. Until next time.