A widely used type of blood pressure medicine may affect women differently from men during a serious heart emergency, according to research led by scientists at the University of Bologna.
The study focused on beta-blockers, medicines that slow the heart and reduce its workload.
Beta-blockers have been used for decades to treat heart and blood pressure problems. They can be prescribed for high blood pressure, an irregular heartbeat, chest pain and some forms of heart failure, although the best medicine depends on each patient’s health and medical history.
The researchers studied people with high blood pressure who had no previous history of heart disease. They wanted to know what happened when these patients were later admitted to hospital with acute coronary syndrome, a term used for emergencies caused by a sudden drop in blood flow to the heart.
One of the best-known forms of acute coronary syndrome is a heart attack. When blood flow is badly reduced or completely blocked, part of the heart muscle may be damaged because it is not receiving enough oxygen.
The study included information from nearly 14,000 patients in 12 European countries. Researchers compared men and women and also looked at whether the patients had been taking beta-blockers before their heart emergency.
Among patients taking beta-blockers, women were more likely than men to develop heart failure after being admitted with acute coronary syndrome. Heart failure does not mean that the heart has stopped. It means the heart is having trouble pumping enough blood to meet the body’s needs.
The difference was especially noticeable in people who had a severe type of heart attack called STEMI. This happens when a major heart artery becomes completely blocked and usually requires urgent treatment to restore blood flow.
Women taking beta-blockers had a risk of heart failure that was nearly 5% higher than men in the study. Among patients with STEMI, the difference was about 6.1%. In contrast, the researchers found no clear difference between women and men who were not taking beta-blockers.
The finding does not prove that beta-blockers directly caused heart failure in these women. Studies based on patient records can show a link, but other differences between patients may also help explain the results.
The researchers suggested that biological differences between women and men could play a role. Female hormones and hormone replacement therapy may affect how the heart and blood vessels respond to medicines, but more research is needed to understand the possible connection.
The study also highlighted how dangerous heart failure can be after a heart attack. Patients who developed heart failure along with acute coronary syndrome had a much higher risk of death than those who experienced the heart emergency without heart failure.
These results add to growing evidence that medicines may not always have exactly the same effects in women and men. Historically, women were often underrepresented in heart research, so scientists are increasingly examining whether sex-related differences should influence treatment decisions.
Importantly, people taking beta-blockers should not stop their medicine because of this study. Suddenly stopping some heart medicines can be risky, and anyone concerned about treatment should speak with a doctor who can consider blood pressure, heart health, other medicines and personal risk factors.
The research was led by Professor Raffaele Bugiardini of the University of Bologna and was published in the American Heart Association journal Hypertension. The findings suggest that researchers may need to study beta-blocker treatment in women more closely so doctors can choose the safest and most effective care for each patient.
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