Starting Heart Patients on Beta-Blockers in Hospital

A study has found that initiating low-dose beta-blockers in heart failure patients prior to discharge from the hospital is better than waiting for two to four weeks after discharge to start the drugs and does not increase the rate of serious adverse events. The results were presented at the 2002 Scientific Sessions of the American Heart Association in Chicago, IL (USA).

In the study, 363 heart failure patients were randomized to one of two groups. One group received a beta-blocker prior to hospital discharge, while the other group could receive the drug only at their physician's discretion but not until at least two weeks after discharge, according to current practice. After 60 days, 91% of patients started on the drug in the hospital were still taking the drug, while only 73% of the physician-discretion group were taking the drug.

"If we can dramatically improve the rate of beta-blocker usage by initiating therapy in-hospital, that would make a major impact on these patients' lives,” said Christopher O'Connor, M.D., a cardiologist at Duke University Medical Center (Durham, NC, USA), one of the directors of the study.

Prior studies have shown that beta-blockers can reduce death and morbidity in heart failure patients by more than 35%. However, standard practice guidelines suggest a waiting period of two to four weeks after discharge because of fears that early initiation might worsen heart-failure symptoms. The current study showed that this did not happen. The beta-blocker used in the study was carvedilol (GlaxoSmithKline, London, UK).



Related Links:
Duke Univ. Medical Center