Spain divided over beta-blocker treatment for heart-attack survivors

Spain's Health Ministry and the country's National Centre for Cardiovascular Research are at loggerheads over what the official recommendation should be for the use of beta-blockers.

In a new study, the research centre has recently concluded that patients who have suffered an uncomplicated heart attack and maintain good cardiac function do not need to take beta-blockers because they provide no benefit, and in certain cases can even cause more harm than good.

Their findings showed that women in particular could be negatively affected by taking beta-blockers.

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The medical report stated that women with little damage after their heart attacks who were given beta-blockers were significantly more likely to have another heart attack or be hospitalised for heart failure. They were also three times more likely to die as a result.

“This was especially true for women receiving high doses of beta-blockers,” said lead study author Dr. Borja Ibáñez, scientific director for Spain’s National Centre for Cardiovascular Research.

It’s important to point out though that the findings in the study only applied to women with a left ventricular ejection fraction above 50 percent, which is considered normal function.

Spain’s Ministry of Health has been highly critical of the conclusions of this study, however. They've warned patients that they should not stop taking their beta-blockers without consulting their doctors first.

In a statement to Cadena SER, Spanish Secretary of State for Health Javier Padilla urged extreme caution with the advice.

He said these medications cannot be withdrawn lightly. "We must be extremely careful when making decisions based on a single study, no matter how new it may be, when we have spent decades gathering evidence on the role of beta-blockers in various cardiovascular pathologies. That's why we must be very cautious about what recommendations we make, especially at an individual level”.

Padilla pointed out that many patients often go to the doctor to be taken off medication after learning about certain studies, but that it may not be the right decision for everyone.

He is very sceptical about the need to modify heart attack treatment, which has been in place over the last 40 years.

Spanish cardiology researchers estimate that there may be 1.2 million people in Spain taking beta-blockers every day without needing them and potentially suffering from side effects as a result.

The research may indeed help doctors to think more about the differences in treating men and women.

General director of the National Centre for Cardiovascular Research in Madrid, Dr. Valentin Fuster added that “These findings will reshape all international clinical guidelines on the use of beta-blockers in men and women and should spark a long-needed, sex-specific approach to treatment for cardiovascular disease”.

Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver agreed and told the website CNN that “Gender has a lot to do with how people respond to medication. In many cases, women have smaller hearts. They’re more sensitive to blood pressure medications. Some of that may have to do with size, and some may have to do with other factors we have yet to fully understand”.