Beta blockers: Kolkata doctors advise against sudden regime shift

KOLKATA: City cardiologists have advised patients against stopping medication following an observation study on the use of beta blockers for heart attack management that claimed the benefit of these drugs may not be as significant as its widespread use.
Cardiologists on Wednesday addressed the anxious calls from patients who wanted to know whether they should continue taking the medicine and advised those who are on this drug regime to take the pills. “In case of any doubt, consult doctors. Stopping the medication suddenly may have repercussions,” a cardiologist said.
Beta blockers are a group of medicine that is used in the management of conditions like angina, irregular heart rhythm, pregnancy-related hypertension, hypertension with coronary artery disease and patients who already have had a heart attack or those who have high risk of suffering a heart attack.
“Beta blockers are the number one drug for preventing heart attack, heart failure, angina and pregnancy-induced hypertension. The newer generation of oral drugs are very effective in preventing sudden cardiac deaths too,” said PK Hazra, cardiologist at AMRI Dhakuria.
The observational study conducted between 2005 and 2016 taking 40,000-plus patients who have had attacks and needed hospital care. The researchers found no significant difference in risk between patients taking beta blockers and those who were not administered the drug.
Doctors said that study was conducted years ago and since then, newer drugs have come out. Cardiologists said there was the need for more detailed study and stronger evidence.
“Evidence still stands that beta blockers are beneficial in patients who already had a heart attack in preventing another attack,” said cardiologist Sunip Banerjee of Kolkata Heart and Lung Centre.
Saroj Mondal, professor of cardiology at IPGMER, said that while beta blockers are not the first choice of drugs for treating hypertension, it is effective in patients with low ejection fraction. “The IV beta blocker used in patients with myocardial infarction is now discouraged because of its potential side-effects. But the new-age oral beta blockers are effective in patients with ejection fraction in preventing sudden pump failure of sudden cardiac death,” said Mondal.
According to doctors, beta blocker is used as the fourth agent, only when the other drugs fail to control hypertension. “If a patient has hypertension, which is not controlled over a long period of time by other three agents, or the patient also has a condition like coronary heart disease, then beta blocker is advised as an additional drug. Patients who have been on regular beta blocker should not do away with it without consulting their doctor,” said cardiologist Suvro Banerjee of Apollo Multispecialty Hospital.