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Beta Blockers in Contemporary Cardiology: Is It Better to Cast Them Out?

Javaid Ahmad Dar1, John Roshan Jacob2

  • 1Department of Cardiology, Christian Medical College, Vellore, India. javaid985@gmail.com.

Korean Circulation Journal
|April 24, 2024
PubMed

Insights

Beta blockers, while beneficial for heart failure with reduced ejection fraction (HFrEF), may be overused. Current data suggests potential harm, including increased stroke risk and reduced exercise capacity, in other cardiovascular conditions.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Beta blockers are widely prescribed for cardiovascular conditions, including hypertension, coronary artery disease (CAD), and heart failure (HF).
  • Their established efficacy in heart failure with reduced ejection fraction (HFrEF) has led to broad clinical application.

Purpose of the Study:

  • To critically review the current indications and clinical utility of beta blockers.
  • To evaluate the potential risks versus benefits of beta blocker use in various cardiovascular diseases beyond HFrEF.

Main Methods:

  • Systematic review of existing data and clinical evidence regarding beta blocker use.
  • Critical analysis of studies investigating beta blockers in hypertension, heart failure with preserved ejection fraction (HFpEF), stable CAD, and atrial fibrillation (AF).

Main Results:

  • Beta blockers are associated with increased stroke risk and atrial fibrillation (AF) in hypertensive patients.
  • In HFpEF, beta blockers have been linked to decreased exercise capacity.
  • No mortality benefit is observed with beta blockers in stable CAD or myocardial infarction with normal systolic function.

Conclusions:

  • Beta blockers may be over-prescribed in conditions such as HFpEF, stable CAD, and hypertension.
  • The benefits observed in HFrEF may not translate to other cardiovascular conditions, potentially causing more harm than good.

Keywords:
Atrial fibrillationCoronary artery diseaseHeart failureHypertension

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