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DEAR MAYO CLINIC: How long do I need to take beta blockers after a heart attack?
ANSWER: Your health care provider likely will consider a number of factors in making that decision. Guidelines recommend beta blocker therapy for three years, but that may not be necessary.
Beta blockers work by blocking the effects of the hormone epinephrine, also called adrenaline. Taking beta blockers reduces your heart rate and blood pressure. This eases the workload on your heart and improves blood flow.
At one point, beta blockers were used in the emergency department to limit heart muscle damage at the time of a heart attack. Current methods for treating a heart attack, which include clot-dissolving medications and surgical opening of blocked arteries — together referred to as reperfusion — improve blood flow without the risks of beta blockers. Immediate use of beta blockers, particularly high doses via IV, can be harmful in people who have decreased blood flow to their organs or whose heart muscle is already weak and pumping ineffectively.
Beta blocker therapy is recommended after emergency heart attack treatment to reduce your risk of irregular heart rhythms, chest pain or another heart attack. In the past, many people have taken beta blockers for years — often indefinitely — after a heart attack. Experts are questioning whether this long-term therapy is necessary in people who don’t have heart failure, especially now that aspirin and cholesterol-lowering statin therapies have become reliable agents in managing heart disease.
Recent evidence suggests that, for most people with normally pumping hearts, beta blockers only may be beneficial in the first year or so after a heart attack.
If you’re still on a beta blocker several years after a heart attack and don’t have heart failure, talk to your health care provider about the pros and cons of maintaining your regimen. (adapted from Mayo Clinic Health Letter) — Dr. Jorge Brenes-Salazar, Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
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