Beta-blockers may increase HF risk in women with new-onset CHD
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Beta-blocker use may precipitate HF in women with new-onset CHD but not in men, researchers found.
“Our study underscores the importance of sex analyses in clinical research studies, which may provide further actionable data,” Raffaele Bugiardini, MD, professor of cardiology at the University of Bologna in Italy, told Healio. “Failure to include both sexes in therapeutic studies are missed opportunities to uncover underlying sex-specific risks. The adverse effect of beta-blocker therapy in women with hypertension is a sex-specific risk.”
In a study published in Hypertension, researchers analyzed data from the International Survey of ACS-Archives from 13,764 patients with ACS and a history of hypertension. The primary outcome was the incidence of HF based on Killip class classification. Researchers also assessed the link between HF and all-cause mortality at 30 days.
Before the index event, beta-blockers were taken by 19% of the patients included in study. The absolute difference was 4.6% for the rate of HF at hospital presentation between women and men who were taking beta-blockers before admission (21.3% vs. 16.7%, respectively; RR = 1.35; 95% CI, 1.1-1.65). Among patients who did not take beta-blockers, the rate of HF at hospital presentation was higher in women, but not to the same extent as in the beta-blocker population (17.2% vs. 16.1%; RR = 1.09; 95% CI, 0.97-1.21).
There was a significant association between sex and beta-blocker therapy for the test of interaction (P = .034). HF was the most powerful predictor of 30-day mortality in both women (OR = 7.54; 95% CI, 5.78-9.83) and men (OR = 9.62; 95% CI, 7.67-12.07).
“After 3 decades of beta-blocker therapy in hypertension, no study has shown that the use of beta-blockers has reduced morbidity or mortality even when compared with the use of placebo,” Bugiardini said in an interview. “Our study provides robust evidence of an interaction between sex and beta-blocker therapy and suggests an increased risk of heart failure among women presenting with incident myocardial infarction.”
ed on stopping beta-blocker therapy in women. He said: “Discontinuing a beta-blocker in an otherwise healthy woman with hypertension and no prior cardiovascular disease is not harmful. It could be wise. Blood pressure in women may be regulated in a more safely way such as using other medications and, of course, through diet and exercise.”
For more information:
Raffaele Bugiardini, MD, can be reached at raffaele.bugiardini@unibo.it.
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