- FRIDAY, July 11 (HealthDay News) — People who are hospitalized
for severe heart failure and have been taking beta blockers should be kept
on those medications while in the hospital, a new study finds.

And if they weren't taking beta blockers already, most of them should
be started on the medications when they leave, according to a report in
the July 15 issue of the Journal of the American College of
Cardiology.

The multi-center study of 2,373 people with heart failure severe enough
for them to suffer decompensated heart failure, in which they suffer fluid
retention, shortness of breath and other complications, is the latest in
the back-and-forth story about the role of beta blockers in heart failure,
which is the progressive loss of the heart's ability to pump blood.

Beta blockers reduce the activity of adrenaline, and so make the heart
beat slower. It was first thought that they were no help against heart
failure, said Dr. James B. Young, chairman of the department of medicine
at the Cleveland Clinic Lerner College of Medicine and a member of the
research team, but experience has shown otherwise. They now are widely
prescribed for the condition.

“But many questions abound, including the best treatment strategy in
the hospital,” Young said. “The best treatment strategy has been hard to
define for hospitalized patients. These are tough questions we haven't had
a lot of evidence about.”

The new study shows a clear benefit for continuing the drug. More than
half of the people hospitalized for heart failure were already taking beta
blockers. Continuing that drug therapy reduced the risk of death by 40
percent and of going back into the hospital by 31 percent. Discontinuing
beta blocker therapy more than doubled the risk of death.

“This is a very important message that beta blockers are an important
therapy for heart failure,” said Dr. Mihai Gheorghiade, a professor of
medicine at Northwestern University Feinberg School of Medicine and a
member of the research group.

Gheorghiade was a leader of a study several years ago which showed that
hospitalized heart failure patients who were not taking beta blockers
benefited from having the therapy started before they left the hospital.
The new study supports the view that “it is safe and effective to start
beta blockers before discharge,” at least in most cases, he said.

“If there are severe signs and symptoms before discharge, you have to
think twice,” Gheorghiade said. “A patient who is not severely
decompensated, with a heart rate below 40 or 50, you can start the drug
before discharge.”

The new study could have a wide application, Young noted. About 1
million Americans are hospitalized each year because of heart failure, he
said. And it marks a complete reversal in what was once the common belief,
that beta blockers would harm people with heart failure.

“If you are on a beta blocker and are admitted with decompensated heart
failure, it is best not to stop the drug, as had been commonly thought
recently,” Young said.

More information

Learn about beta blockers and other drugs for heart failure from the American Heart Association.