Heart failure is a serious and growing health problem in the United States, causing major health complications and adding billions of dollars to healthcare costs.
It happens when the heart can’t pump enough blood to meet the body’s needs, leading to symptoms like shortness of breath, fatigue, and swelling from fluid buildup.
While many people think of heart failure as a condition where the heart is too weak to pump properly, there’s another type that’s just as common.
In this version, known as “stiff heart” heart failure, the heart’s pumping power is normal—but the heart is too stiff to relax and fill with blood properly. This condition is also called heart failure with preserved ejection fraction, or HFpEF.
A new study from the University of Vermont has raised concerns about a popular treatment used in many heart failure patients—beta-blockers.
These medications are often prescribed to help the heart by lowering blood pressure, controlling heart rhythms, and reducing the risk of future heart attacks. They are life-saving for people with “weak heart” heart failure, where the heart’s pumping strength is reduced.
But for those with “stiff heart” heart failure, the benefits of beta-blockers are much less clear. Unfortunately, there are few proven medications for this type of heart failure, so doctors often prescribe drugs like beta-blockers based on what works for other forms of the condition.
The research team reviewed data from a large clinical trial called the TOPCAT study, which included patients with HFpEF. About 80% of the people in the study were taking beta-blockers. The researchers found something concerning—those taking beta-blockers were 74% more likely to be hospitalized for heart failure.
The study suggests that beta-blockers might not just be unhelpful for these patients—they could be making symptoms worse. In “stiff heart” failure, the heart already has trouble relaxing. Beta-blockers may raise the pressure inside the heart, which can lead to more fluid retention and make it harder to breathe—two major symptoms of heart failure.
This study is important because it highlights a big gap in our understanding. While beta-blockers are widely used and well-studied in one type of heart failure, they haven’t been properly tested in people with HFpEF. What helps one group of patients may actually hurt another.
For patients and caregivers, this is a reminder to talk with healthcare providers about the risks and benefits of each medication. It’s especially important for those with “stiff heart” heart failure to ask whether their treatment plan is backed by solid evidence for their specific condition.
The researchers, led by Dr. Timothy Plante, hope these findings will lead to more studies focused on better treatments for HFpEF, which currently lacks good options. The study was published in JAMA Network Open and points to the need for more personalized care strategies for people living with different types of heart failure.
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