Why Should I Take a Beta-Blocker After a Heart Attack?
Beta-blockers prevent death in heart attack survivors. But like any other medication, there can also be side effects.

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Image of pills in front of heart Why Should I Take a Beta-Blocker After a Heart Attack?

The days and weeks following a heart attack bring relief and new challenges for survivors. Along with starting fresh habits, like healthy eating and exercising, most heart attack survivors also have to take new medications. A beta-blocker is one of the drugs often started just hours after being admitted to the hospital for a heart attack. It is often a drug that people have to take for the rest of their lives.

What are beta-blockers?
Beta-blockers slow the heart rate and ease the workload on the heart. These medications work by blocking the effects of adrenaline on the body. They are used to treat high blood pressure and heart problems as well as some non-cardiovascular conditions, such as glaucoma and migraine.

What does the evidence show?
Studies have shown that when given within hours after heart attack symptoms begin, beta-blockers can help cut the risk of death. They also reduce the risk of a second heart attack when used long-term.

The risk of death and nonfatal heart attack drops by 20 percent to 30 percent in heart attack survivors who take these drugs, compared to heart attack survivors who do not take it. The greatest benefit was seen in the elderly, including those with other conditions, such as diabetes or heart failure.

Evidence supporting the benefits of beta-blockers is so strong that the American College of Cardiology recommends their use for most patients as part of their guidelines for treatment of a heart attack and for angina.

What are the benefits?

  • There is a lot of scientific evidence that beta-blockers cut the risk of death following a heart attack and lower the chance of having another heart attack.
  • Beta-blockers can treat several conditions, including high blood pressure, irregular or fast heart rate and chest pain.
  • They are relatively inexpensive. Several generic versions are available. They are often cheaper than brand-name drugs.

What should I watch out for?

  • They could have a negative effect on other medical conditions, such as diabetes, asthma or thyroid disease.
  • They can cause side effects. A few examples are:
    • Headache
    • Depression
    • Trouble sleeping
    • Sexual dysfunction

Let your doctor know if you are having any side effects from your medication.

What else do I need to know about beta-blockers?

  • You may need to take the beta-blocker for the rest of your life.
  • Beta-blockers can make some other medical conditions worse. Be especially careful if you have:
    • Diabetes. Beta-blockers may hide the effect of low blood sugar. So if you have diabetes, you may need to check your blood sugar levels more frequently and adjust your diabetes medicine accordingly.
    • Asthma. Beta-blockers can make asthma worse. So if you have asthma and you still need to take a beta-blocker, your doctor will monitor your asthma closely and change your asthma action plan if needed.
  • Some medications can increase or decrease the effects of the beta-blocker. Be sure to tell your doctor about all the other medications you take.
  • Stopping a beta-blocker suddenly increases the workload on the heart and could cause chest pain or a heart attack. Never stop taking this or any medication without first talking to your doctor.
By Louis Neipris, MD, Staff Writer
Created on 04/06/2010
Updated on 04/07/2010
Sources:
  • Antman EM, Hand M, Armstrong PW, et al. 2007 focused update of the acc/aha 2004 guidelines for the management of patients with ST-Elevation Myocardial Infarction. Journal of the American College of Cardiology. 2008;51:210-247.
  • Fraker TD Jr, Fihn SD. 2007 Chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina. Journal of the American College of Cardiology. 2007;50(23):2264-2274.
  • Phillips KA, Shlipak MG, Coxson P, et al. Health and economic benefits of increased [beta]-blocker use following myocardial infarction. Journal of the American Medical Association. 2000;284:2748-2754.
  • National Heart Lung and Blood Institute. How is a heart attack treated?
  • American Heart Association. Cardiac medications at-a-glance.
  • National Library of Medicine. Propranolol oral: MedlinePlus drug information.
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