Widely used heart drugs linked to higher heart failure risk

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Heart failure is a leading driver of health care costs in the United States. Heart failure occurs when the heart cannot meet the body’s demands.

About half of patients have heart failure characterized by a normal squeeze but impaired relaxation of the heart muscle from a “stiff heart”.

A recent study from the University of Vermont found that most patients with this type of heart failure take beta-blocker medications despite unclear benefits from their regular use.

Beta-blockers, also spelled β-blockers, are a class of medications that are used to manage abnormal heart rhythms, and to protect the heart from a second heart attack after a first heart attack.

Beta-blockers can lower stress on the heart and blood vessels. Doctors mainly prescribe beta-blockers to manage heart symptoms, such as angina and high blood pressure.

According to the team, a big problem with ‘stiff heart’ heart failure is that doctors don’t have effective medical therapies. So, instead, they use the same medications that work for ‘weak heart’ heart failure.

Because beta-blockers save lives in ‘weak heart’ heart failure, doctors assume they are also effective in ‘stiff heart’ heart failure patients—this assumption may be wrong.

In the study, the team analyzed data from the National Institutes of Health-funded TOPCAT study.

It was a trial of the medication spironolactone in patients with “stiff heart” heart failure. About four out of five study participants were on beta-blockers.

The researchers found beta-blocker use to be a risk factor for hospitalizations for heart failure among these patients with “stiff heart” heart failure.

Beta-blocker use was linked to a 74% higher risk of heart failure hospitalizations among participants with heart failure and a normal pump function.

The team says in ‘stiff heart’ heart failure, the heart is less able to relax and fill with blood. Beta-blockers appear to increase pressures inside the heart.

This may lead to symptoms like worsening shortness of breath and retention of fluid

Despite their common use, the researchers note that beta-blocker use in “stiff heart” heart failure has not been sufficiently studied.

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The research was published in JAMA Network Open and conducted by Timothy Plante et al.

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