MASTERING MEDICATIONS FOR A HEALTHY HEART: BETA-BLOCKERS
Here’s another case where a drug has been scientifically demonstrated to decrease the likelihood of a subsequent heart attack following an initial event. Nine out of ten studies have shown that beta-blocking drugs, which interfere with nervous stimulation of cells in the heart called beta-adrenergic receptors, increase heart attack patients’ chances of survival. The beta-blockers literally slow down the beat of the heart. Since it doesn’t work as hard at the slower rate, the heart muscle needs less oxygen. And since oxygen-deficit to the heart muscle is the heart patient’s biggest concern, the beta-blockers help to prevent angina attacks as well as heart attacks.
It’s interesting to note that some doctors and medical students have been known to “pop” a beta-blocker tablet just before delivering a presentation. Why? The medication prevents the rapidly beating, pounding heart that many people experience when they have to do any public speaking. You may find this to be a very pleasant “side effect” of the drug.
Despite the generally good publicity in the medical literature, beta-blockers have received their share of criticism. First, studies have shown that the drugs can lower the levels of the protective HDL cholesterol, thus balancing out the beneficial effects. Second, since beta-blockers slow down heartbeat, will they interfere with the goals of exercise in the recovery process? Fortunately, studies have demonstrated that even those taking the drugs continue to achieve the benefits accruing to physical exercise. On the other hand, it may be possible to duplicate the benefits of the beta-blockers merely by doing sufficient exercise regularly to slow the heart rate at test. Again, we have research data to prove that this can be achieved by patients who do strenuous exercise on a regular basis. In those studies, exercise and drugs had a similar effect on resting heart rate.
But the biggest controversy regards the length of time beta-blockers should be prescribed. The protection against subsequent heart attack has been proved for only the critical six months to a year after the initial event. After that, critics maintain, there’s just no reason to continue the drug.
On the other hand, beta-blockers also have an antihypertensive effect. That alone may be reason enough for your doctor to want you to stay on the medication beyond the first year. Talk with him about it. And, of course, if you demonstrate that your exercise program is paying off with improved resting heart rates, decreased blood pressure and fewer problems with angina pectoris, it’s likely that your doctor will go along with gradually cutting down the dosage and perhaps even eliminating it altogether.
But here’s a strong note of caution: do not stop taking beta-blockers abruptly or without your physician’s consent. There have been instances of patients stopping their dosage suddenly and suffering a heart attack as a result.
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Cardio & Blood/ Cholesterol
