Feinberg
Northwestern Medicine | Northwestern University | Faculty Profiles

News Center

  • Categories
    • Campus News
    • Disease Discoveries
    • Clinical Breakthroughs
    • Education News
    • Scientific Advances
  • Press Releases
  • Media Coverage
  • Podcasts
  • Editor’s Picks
    • COVID-19
    • Cardiology
    • Cancer
    • Neurology and Neuroscience
    • Aging and Longevity
    • Artificial Intelligence in Medicine
  • News Archives
  • About Us
    • Media Contact
    • Share Your News
    • News Feeds
    • Social Media
    • Contact Us
Menu
  • Categories
    • Campus News
    • Disease Discoveries
    • Clinical Breakthroughs
    • Education News
    • Scientific Advances
  • Press Releases
  • Media Coverage
  • Podcasts
  • Editor’s Picks
    • COVID-19
    • Cardiology
    • Cancer
    • Neurology and Neuroscience
    • Aging and Longevity
    • Artificial Intelligence in Medicine
  • News Archives
  • About Us
    • Media Contact
    • Share Your News
    • News Feeds
    • Social Media
    • Contact Us
Home » Low Dose Beta-Blockers As Effective As High Dose After a Heart Attack

Clinical Breakthroughs

Low Dose Beta-Blockers As Effective As High Dose After a Heart Attack


By Marla PaulSep 21, 2015
Share
Facebook Twitter Email

Heart attack patients live as long – or even longer – on one-quarter the suggested dose

Jeffrey-Goldberger_160
Jeffrey Goldberger, MD, professor of Cardiology in the Department of Medicine, was the lead investigator of the study that found low doses of beta-blockers were as effective as high doses after heart attacks.

In a surprising new finding, heart attack patients treated with a substantially lower dosage of beta-blockers than used in earlier clinical trials showing their effectiveness survived at the same rate, or even better, than patients on the higher doses used in those trials.

In fact, patients who received one-fourth of the original clinical trial dose had up to a 20 to 25 percent decrease in mortality compared to the full dose group.

About 90 percent of patients who have had a heart attack currently receive beta-blockers, a class of drug commonly prescribed to improve survival and prevent future heart attacks. Beta-blockers block the effects of adrenaline on the heart, reduce irregular heartbeat (arrhythmia) and help prevent heart failure.

No one was more surprised at the results than lead investigator Jeffrey Goldberger, MD, professor of Cardiology in the Department of Medicine. He launched the study when he discovered heart attack patients were being treated with much lower doses of beta-blockers than were used in clinical trials.

“I thought that was terrible quality of care,” Dr. Goldberger said. “We set out on a mission to show if you treat patients with the doses that were used in the clinical trials, they will do better. We expected to see patients treated with the lower doses to have worse survival. We were shocked to discover they survived just as well, and possibly even better.”

New research should be conducted to determine the most appropriate beta-blocker dose for individual patients to get the optimal benefit, said Goldberger, also director of the program in cardiac arrhythmias at the Center for Cardiovascular Innovation. The earlier clinical trials did not assess the effects of different doses.

The study was published in the Journal of the American College of Cardiology.

Patients are treated with lower doses for a variety of reasons. There may be concern about possible side effects that may include fatigue, sexual dysfunction and depression. In addition, when patients are started on conservative, low doses in the hospital after a heart attack, they return home so quickly, there is little time to adjust the dosage, Dr. Goldberger said.

The study examined data in a multicenter registry on 6,682 patients who had a heart attack. About 90 percent were receiving beta-blockers. All the patients on beta-blockers survived longer than those who did not receive the drugs. The raw, unadjusted data showed that of the people who received the full dose, 14.7 percent died within two years; of those receiving the half dose, 12.9 percent died; for the quarter dose, 9.5 percent died and for the one-eighth dose, 11.5 percent died.

OBTAIN (Outcomes of Beta-Blocker Therapy After Myocardial Infarction) is an observational multicenter registry in which beta-blocker dosing information was collected in patients with an acute heart attack at participating centers to assess the effect of dose on survival.

“There is probably not one right dose for every single patient,” Dr. Goldberger said. “It doesn’t make sense that the same dose will work for an 80-year-old frail man who had a small heart attack as a burly 40-year-old man with a huge heart attack.”

“We now need to figure out how to dose it in individual patients,” Dr. Goldberger said. “That’s something no one has considered in the decades that we have been using this medication. This huge gap in knowledge has been completely unexplored. Since this is medicine we use in every single heart attack patient, we ought to figure out how to use it properly.”

Other Northwestern authors include Robert Bonow, MD, Max and Lilly Goldberg Distinguished Professor of Cardiology; Lei Liu, PhD, associate professor of Biostatistics in the Department of Preventive Medicine; and Haris Subačius.

The research was supported by grant 5U01HL080416 from the National Heart, Lung and Blood Institute at the National Institutes of Health.

Members of the media, please contact Marla Paul via e-mail at marla-paul@northwestern.edu or at (312) 503-8928 for more information about this story.

Cardiology Hospital Medicine Pharmacology Research
Share. Facebook Twitter Email

Related Posts

Investigating Protein’s Role in Hearing Loss

Mar 27, 2023

Sex-Specific Mechanisms for Major Depressive Disorder Identified in Response to Dysregulated Stress Hormones

Mar 23, 2023

Pre-Surgery Immunotherapy May Increase Survival in Advanced Melanoma

Mar 23, 2023

Comments are closed.

Latest News

Investigating Protein’s Role in Hearing Loss

Mar 27, 2023

Sex-Specific Mechanisms for Major Depressive Disorder Identified in Response to Dysregulated Stress Hormones

Mar 23, 2023

Pre-Surgery Immunotherapy May Increase Survival in Advanced Melanoma

Mar 23, 2023

Hormone Therapy Plus Current Treatments Improves Survival in Prostate Cancer

Mar 22, 2023

How ChatGPT Has, and Will Continue to, Transform Scientific Research

Mar 21, 2023
  • News Center Home
  • Categories
  • Press Release
  • Media Coverage
  • Editor’s Picks
  • News Archives
  • About Us
Flickr Photos
20230317_NM651
20230317_NM610
20230317_NM569
20230317_NM537
20230317_NM331
20230317_NM323
20230317_NM316
20230317_NM336
20230317_NM626
20230317_NM662
20230317_NM655
20230317_NM642

Northwestern University logo

Northwestern University Feinberg School of Medicine

RSS Facebook Twitter LinkedIn Flickr YouTube Instagram
Copyright © 2023 Northwestern University
  • Contact Northwestern University
  • Disclaimer
  • Campus Emergency Information
  • Policy Statements

Type above and press Enter to search. Press Esc to cancel.