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Related Experiment Videos

Beta-adrenergic blocker withdrawal.

W H Frishman

    The American Journal of Cardiology
    |May 15, 1987
    PubMed
    Summary
    This summary is machine-generated.

    Abruptly stopping beta-blocker medication can increase the risk of heart attack and unstable angina due to heart rate overshoot. Gradual withdrawal may reduce these serious beta-blocker withdrawal risks.

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    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Long-term beta-blocker therapy is common for angina.
    • Abrupt cessation of beta-blockers may precipitate adverse cardiovascular events.

    Purpose of the Study:

    • To review the mechanisms and clinical implications of beta-blocker withdrawal.
    • To discuss strategies for mitigating beta-blocker withdrawal reactions.

    Main Methods:

    • Literature review of studies on beta-blocker withdrawal.
    • Analysis of proposed pathophysiological mechanisms.
    • Evaluation of clinical observations and surgical protocols.

    Main Results:

    • Abrupt beta-blocker withdrawal can cause heart rate overshoot, increasing myocardial oxygen demand.

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  • Mechanisms include increased beta-receptor sensitivity/numbers and enhanced platelet aggregability.
  • Withdrawal reactions are observed in angina patients and perioperatively.
  • Partial agonist beta-blockers may have less severe withdrawal effects.
  • Maintaining beta-blocker therapy perioperatively reduces risk.
  • Gradual withdrawal in outpatients with angina appears safer.

    • Conclusions:

    • Abrupt beta-blocker withdrawal poses significant cardiovascular risks, particularly in angina patients.
    • Gradual tapering is a recommended strategy to minimize withdrawal reactions.
    • Further research is needed on gradual withdrawal in hypertensive patients.