BP drug key in hospitalized heart failure patients

By Megan Rauscher

NEW YORK (Reuters Health) - Patients hospitalized for heart failure should continue to take a blood pressure drug known as a beta blocker, a team of US heart doctors report, because it is associated with markedly better outcomes compared to hospitalized heart failure patients in whom beta-blocker therapy is stopped or never started.

"These findings suggest that routine discontinuation of beta-blocker therapy on hospital admission is neither necessary nor advisable, and the vast majority of patients hospitalized for heart failure are eligible for beta-blocker therapy to be continued," Dr. Gregg C. Fonarow told Reuters Health.

Fonarow of the University of California-Los Angeles Medical Center and colleagues determined the relationship between continuing or withdrawing beta-blocker therapy and outcomes in 5,791 patients hospitalized with heart failure -- a condition in which a heart damaged by heart attack or other causes gradually loses its pumping power.

Among 2,373 patients who were eligible for beta-blockers at discharge, there were 1,350 (57 percent) who were receiving beta-blockers prior to admission and continued on therapy; 632 (27 percent) newly started on a beta-blocker; 79 (3 percent) in whom therapy was withdrawn; and 303 (13 percent) who did not receive a beta-blocker.

Results suggest, according to Fonarow, that "the most important" factor influencing whether a patient hospitalized with heart failure will survive the next 60 to 90 days is continuing or newly starting beta-blocker medications during hospitalization.

"Patients who are hospitalized for heart failure and have been taking beta-blockers," he concluded, "should be kept on this medication while in the hospital, and if they weren't taking beta blockers already, patients should be started on this medication before they are discharged."

SOURCE: Journal of the American College of Cardiology, July 15, 2008.