Beta Blockers After Heart Attack

Beta Blockers After Heart Attack

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Chest pain during exertion is typical during a heart attack.

BananaStock/BananaStock/Getty Images

The human heart is a pump that relies upon specialized muscle tissue called myocardium to propel blood through its chambers into the lungs and the remainder of the body. Heart muscle is damaged when arteries supplying it become clogged. The result is a myocardial infarction, or "heart attack." Beta blocker drugs are commonly used to reduce the risk of death from a heart attack and decrease the chance of having repeated attacks.

Limiting Heart Muscle Damage

The risk of death from heart attack increases with the amount of heart muscle that is damaged. Beta blockers reduce heart rate, blood pressure and tension on the heart muscle and thereby decrease its vulnerability to damage caused by reduced oxygen supply from the blocked artery. In a February 2001 article published in "Circulation," doctors demonstrated that a beta blocker was more effective in reducing the size of heart attack than another commonly used class of drugs. The guidelines of the American Heart Association recommend caution and selectivity in routine administration of intravenous beta blockers, however, because of the risk of inducing heart failure.

Preventing Dangerous Heart Rhythms

Heart attacks sometimes disrupt the normal rhythm of the heart. The most dangerous abnormal rhythm after heart attack is ventricular fibrillation, in which the damaged muscle begins to twitch uncontrollably and blood flow is significantly and often lethally reduced. Ventricular fibrillation is most often associated with fatal heart attacks. Beta blockers reduce the occurrence of ventricular fibrillation, and the American Heart Association recommends their early use in heart attack patients who do not have low blood pressure or heart failure.

Prolonged Use of Beta Blockers

In a review published in February 2012 in "Current Cardiology Reviews," prolonged use of beta blockers after a heart attack was shown to reduce the risk of adverse heart events, including second heart attacks, ventricular fibrillation and sudden death. The benefits were seen principally in high-risk patients older than age 60 and became apparent within the first year of treatment. There is no firm scientific evidence for how long to continue beta blocker treatment after a heart attack. However, 1 to 3 years is the common practice, according to the authors of the review.

Not for Everyone

Although previous guidelines recommended broad, early use of beta blockers following a heart attack, the recognition that some patients are harmed rather than helped by these medications resulted in discontinuation of that standard in 2009. All medications, including beta blockers, have the potential to cause harm in the long and short term. In deciding whether to use beta blockers and when to discontinue the medication, if used, doctors must evaluate each person's situation individually, taking into account all potential risks and benefits.


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