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Beta-Blockers Post-MI May Not Be Appropriate in Dementia

Jan
30

Date: January 30th, 2017

When not to use beta-blockers

The researchers said that there was a significant reduction of death almost a quarter as a result of using the drug by. However, the same beneficial drugs could be linked to a risk increase by 34 percent for the moderate or severe dementia patient, making it almost impossible for them to carry out their everyday activities.

No single perfect cardiovascular care

In reviewing the findings, one heart expert noted that the implication of this is there can’t be a single perfect approach when it comes to cardiovascular care.

Dr. Kevin Marzo. He is chief of cardiology at Winthrop-University Hospital in Mineola, N.Y. said that the study results point out the “the importance of personalizing medical care for an individual elderly patient following a heart attack.”

Marzo continued to explain that “Routine use of beta blockers following [heart attack] may cause harm in high-risk populations … such as the elderly with dementia and fragility … and their use should be assessed on an individual level.”

Beta blockers are very common among the affected patients and consist of medications like atenolol, acebutolol, bisoprolol, nadolol, metoprolol, propranolol and nebivolol. The diseases that these medications are used to treat are chest pain, abnormal heart rhythms, heart failure and high blood pressure.

The study authors said that previously done studies suggested that taking the drugs lowered the risk of death by 25 – 30 percent.

How the study was done

To carry out this new study, the researchers brought together 11,000 nursing home residents who were 65 years of age and above and had previously had a heart attack which they survived. Shortly after the survival, half of these patients had been placed under beta blockers medication.

They reported that in 90 days time, the beta blockers lowered the number of deaths. However, for the patients with dementia, using the drug could be linked to a one-third increase in the inability to independently go about their day to day tasks. The study could not establish the cause-and-effect.

This effect could not be recorded in the patients who had mild or no dementia.

Dr. Michael Steinman, a professor of geriatrics at the University of California, San Francisco, and the affiliated San Francisco VA Health Care System said that “There is a lot of interest in the potential harms of drugs in older adults and how they affect one’s quality of life by contributing to problems such as fatigue, dizziness and a general sense of being off.”

He continued to explain that the findings point out “how the potential mortality benefits of drugs can be balanced by harms to quality of life in older adults, and how to manage that risk-benefit trade-off.”

His sentiments were supported by Dr. Gisele Wolf-Klein, who said that medication decisions must also have the aspect of quality-of-life considerations. She is the director of geriatric education at Northwell Health in Great Neck.

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