Statins, Beta Blockers Help Block First Heart Attack

These drugs do more than just reduce cardiovascular disease, study suggests

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By Meryl Hyman Harris
HealthDay Reporter

MONDAY, Feb. 20, 2006 (HealthDay News) -- Doctors know that cholesterol-busting statins and beta blocker blood pressure medicines help prevent cardiovascular disease.

Now, new research suggests they may also ward off the heart attacks that sometimes appear as the first sign of cardiovascular trouble.

"Probably the most surprising thing was that among all of the different medications that we examined [including ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics and alpha-blockers], statins and beta blockers were the only heart drugs that seemed to protect against having a heart attack as the first symptom of heart disease, " said study author Dr. Alan Go, a research scientist with Kaiser Permanente's Division of Research in Oakland, Calif.

Of nearly 1,400 Kaiser Permanente patients studied in Northern California, those who had heart attacks were much less likely to have received statins and/or beta blockers than patients who experienced chest pain and pressure (angina) with exercise as their warning signs of heart disease.

The patients who had heart attacks rather than angina were most often male, smokers, physically inactive and hypertensive, though when those details were factored out, the statins and beta blockers still appeared to make the difference.

Patients who had already been diagnosed with coronary disease were not included in the study.

The study, published in the Feb. 21 issue of Annals of Internal Medicine, also found that women were less likely than men to suffer a heart attack as their first heart disease symptom.

How might statins and beta blockers fight first heart attack? Go said it appears that statins work through lowering LDL or "bad" cholesterol. They may also lower arterial inflammation, keep cholesterol plaque in blood vessels from rupturing, and improve blood vessel performance.

For their part, beta blockers lower blood pressure and slow down the heart rate, which together lower stress on the heart, he noted. These drugs "may also improve the flexibility of blood vessels, which allows them to respond better to stress," Go said.

"We believe that our study provides more evidence that persons who are at increased risk for heart disease should consider talking with their doctor about whether they should be taking these medications," he said.

Not everyone is convinced it is time to change practice, however.

"There are clear guidelines about who should take statins and beta blockers, and we should continue to follow those," said Dr. Harlan M. Krumholz, a professor of cardiology at Yale University School of Medicine. "This study doesn't clarify if there are additional groups who should be treated."

Krumholz said the real question is, "What strategy would keep people from having either complication?"

The researchers conceded that they did not have "all possible confounding factors, including use of aspirin therapy," and they stressed that more study is needed.

More information

For more on avoiding heart attack, head to the American Heart Association.

SOURCES: Alan Go, M.D., scientist, division of research, Kaiser Permanente, Oakland, Calif.; Harlan M. Krumholz, M.D., professor, cardiology, Yale University School of Medicine, New Haven, Conn.; Feb. 21, 2006, Annals of Internal Medicine

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