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Differential effect of β-blockers for heart rate control in coronary artery disease

Alberto Cordero1, Vicente Bertomeu-González, Pilar Mazón

  • 1Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain. acorderofort@gmail.com

Clinical Cardiology
|November 16, 2011
PubMed

Insights

Resting heart rate (RHR) is poorly controlled in coronary artery disease (CAD) patients. Beta-blockers (BBs) like atenolol, bisoprolol, and metoprolol are most effective for RHR control in daily practice.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Resting heart rate (RHR) is a significant risk factor for cardiovascular disease (CVD).
  • Beta-blockers (BBs) are crucial in managing coronary artery disease (CAD) and reducing RHR.
  • Effective RHR control remains a challenge in clinical practice for stable cardiovascular disease patients.

Purpose of the Study:

  • To evaluate the control of RHR in patients with stable coronary artery disease (CAD).
  • To identify which beta-blockers (BBs) are most effective in achieving target RHR <70 bpm.
  • To assess the association between BBs, calcium channel blockers (CCBs), and RHR control.

Main Methods:

  • An observational, cross-sectional, multicenter study involving 2897 CAD patients.
  • Data collected included patient history, risk factors, and current treatments.
  • Controlled RHR was defined as <70 beats per minute (bpm).

Main Results:

  • Patients on BBs had significantly lower RHR (67.2 bpm) compared to those not on BBs (73.0 bpm).
  • Atenolol, bisoprolol, and metoprolol were independently associated with controlled RHR (<70 bpm).
  • No significant association was found between non-dihydropyridine CCBs and RHR control.

Conclusions:

  • RHR control is suboptimal in CAD patients in daily clinical practice.
  • Specific BBs, namely atenolol, bisoprolol, and metoprolol, are independently associated with achieving target RHR.
  • BBs remain the most effective therapy for RHR reduction in CAD patients.
Abstract

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