Overall 25,517 (46.4%) patients in the study sample were prescribed beta-blockers at discharge. The rate of beta-blocker use declined as COPD or asthma severity increased (p , 0.001). Beta-blockers were prescribed for 50.3% of patients without COPD or asthma, 37.4% of patients with COPD or asthma not prescribed beta-agonists, 25.2% of patients with COPD or asthma prescribed beta-agonists, and 12.5% of patients with severe COPD or asthma. Over 91% of patients discharged on beta-blockers were prescribed beta1-selective agents. After adjusting for demographic and clinical factors, patients with COPD or asthma continued to be less likely to be prescribed beta-blocker therapy compared with patients without pulmonary disease (odds ratio [OR] 0.65) (95% confidence interval [CI] 0.62 to 0.69, for patients with COPD or asthma not prescribed beta-agonists, OR 0.38 [95% CI 0.34 to 0.41] for patients with COPD or asthma prescribed beta-agonists but not prescribed oral steroids or admitted in the prior year, ...
Eesti Teadusinfosüsteem koondab informatsiooni teadus- ja arendusasutuste, teadlaste, teadusprojektide ning erinevate teadustegevuste tulemuste kohta.
Postsystolic shortening (PSS), a positive myocardial velocity after aortic valve closure as assessed by tissue Doppler imaging (TDI), is a common finding in patients with myocardial disease. Beta-blocker therapy is shown to improve both global and regional myocardial function. The aim of the present study was to examine whether beta-blocker therapy might reduce incidence and magnitude of PSS in patients with nonischemic dilated cardiomyopathy. Before and a few months after beta-blocker (carvedilol) therapy, 19 patients (7 men and 12 women, age 59±13 years) underwent conventional echo-assessment and TDI. From the apical two, four, and long-axis views, we constructed time velocity curves at the 12 basal and mid-myocardial segments of the left ventricular (LV) walls. PSS was defined if the positive myocardial velocity after aortic valve closure was greater than the ejection peak (Figure⇓). The number of PSS was counted before and after beta-blocker therapy. Beta-blocker therapy decreased LV ...
A recent study by Australian researchers suggests that cardiovascular medications known as beta-blockers can decrease the risk of osteoporosis-related bone fractures by half.
The percentage of patients 18 years of age and older during the measurement year who were hospitalized and discharged from July 1 of the year prior to the measurement year to June 30 of the measurement year with a diagnosis of acute myocardial infarction (AMI) and who were prescribed persistent beta-blocker treatment for six months after discharge
The main finding of the present meta-analysis indicates that the effect of beta-blockers in patients with HF and AF is significantly different from the effect of these drugs in patients with HF and sinus rhythm. Indeed, beta-blockers were not found to have a favorable effect on HF hospitalizations or mortality in 1,677 AF patients who had been enrolled in placebo-controlled, randomized studies.. This finding is important as most patients with HF and AF receive beta-blocker treatment. Beta-blockade is recommended in the current guidelines for HF and AF treatment, albeit for different indications (1,23). In HF treatment guidelines, beta-blockers are recommended for all patients in order to reduce morbidity and mortality, without differentiation regarding rhythm. As such, these drugs are part of the standard medical therapy for all patients with HF and reduced LVEF. In addition, beta-blocker therapy has been shown to prevent new onset or recurrent AF in patients with HF (15,24) after myocardial ...
This analysis demonstrates that trial results of beta-blocker therapy in patients with CHF are consistent with a beneficial effect on total and cardiovascular mortality. The overall decrease in the odds of death was 31%, with one death prevented per 35 patients treated. The benefit from beta-blockade was consistent over the studies examined; however, it was most pronounced in the studies of carvedilol, which account for 55% of all included patients.. Previous studies, including a meta-analysis ([21]), have demonstrated that beta-blockade can improve left ventricular ejection fraction, symptoms and morbidity indices ([14-20]). The finding of improved mortality with beta-blockade has also been suggested by many previous studies, but most have lacked the statistical power to find even moderate improvements in survival ([14, 15, 17, 18, 33, 38, 42-44, 49, 56]). The results from this meta-analysis increase confidence in the hypothesis that beta-blockade reduces mortality in heart failure.. Previous ...
According to the reports from Ministry of Health in each country, the average life spans were expanded over the past century. This trend is expected to be extended furt..
Andrews et al performed the first meta-analysis in this area. They found that 13 of 19 studies investigating the benefit of prophylactic beta-blockers showed a significant benefit in favour of giving prophylaxis. Pooling all these results showed a reduction in AF from 34% to 8.7% from studies involving 1,549 patients. Interestingly no difference was shown when pre-operative beta-blocker studies were compared to post-operative studies. No benefit was shown in 8 studies assessing either verapamil or digoxin as AF prophylaxis. They also showed that the mean ventricular rate was significantly lower in beta-blocked patients when they did go into AF, with a mean rate 24bpm slower than controls. They did caution that most patients in these studies were young, male and had good ejection fractions and had been on beta-blockers pre-operatively. Kowey et al in 1992 pooled data from 7 studies containing 1,418 patients, and found a reduction in AF from 20% to 9.8%. In addition they pooled data from 2 studies ...
Aims: We sought to: (1) estimate the proportion of patients who initiated beta-blocker therapy after acute myocardial infarction (AMI) in Regione Emilia-Romagna (RER); (2) examine predictors of post-AMI beta-blocker initiation; and (3) assess adherence to such therapy. Methods and Results: Using healthcare claims data covering all of RER, we identified a cohort of 24,367 patients with a hospitalization for AMI between 2004 and 2007, who were discharged from the hospital alive and without contraindications to beta-blocker therapy. We estimated the proportion of eligible patients with at least one prescription for a beta-blocker following discharge and performed a multivariable logistic regression analysis to identify independent predictors of post-AMI beta-blocker initiation. We computed the proportion of days covered (PCD) as a measure of medication adherence at 6 and 12 months post-discharge. Following discharge, 16,383 (67%) cohort members initiated beta-blocker therapy. Independent predictors of beta
Ivabradine is a novel heart rate lowering medicine for the symptomatic management of stable angina pectoralis and symptomatic chronic heart failure. Ivabradine, brand name Corlanor, was approved by the FDA in April 2015 for the treatment of chronic heart failure in patients with an ejection fraction of ≤35%, in sinus rhythm with resting heart rate ≥70 beats per minute, who are not on beta-blockers due to contraindications or already receiving maximum beta-blocker dose. Ivabradine acts by selectively inhibiting the
Beta-blockers, a type of drug frequently prescribed for people with heart disease, may not reduce the risk of a second heart attack, death, or stroke in people with coronary artery disease (CAD). In people with risk factors for heart disease, beta-blockers may increase the risk of such events, according to findings from a recent large observational study conducted by a team of investigators from the Cardiac and Vascular Institute at NYU Langone Medical Center.
Beta Blockers - MedHelps Beta Blockers Center for Information, Symptoms, Resources, Treatments and Tools for Beta Blockers. Find Beta Blockers information, treatments for Beta Blockers and Beta Blockers symptoms.
Between June 2004 and April 2008, 497 statin-naive patients scheduled for vascular surgery were included in the trial at Erasmus MC Rotterdam, The Netherlands. Patients were randomised to receive either placebo or fluvastatin extended release at a dose of 80mg once daily. Treatment was started at the outpatient clinic on the day of randomisation, median 37 days prior to the surgical procedure and was continued at least during the first 30 days after surgery. Inflammatory markers at baseline, including hs-CRP and IL-6 were assessed in patients allocated to fluvastatin or placebo. At hospital, admission levels of hs-CRP and IL-6 were significantly lower in patients on fluvastatin (respectively 6mg/L vs. 4.66mg/L, p=.030 and 8.45pg/mL vs 5.75pg/mL, p=.024). The primary analysis was intention-to-treat and involved all patients who were randomly assigned to either fluvastatin or placebo. Directly after surgery, study treatment was temporarily discontinued in 115 (23%) patients for a median duration ...
Methods and Results-The study included 5926 consecutive patients who underwent CABG and were discharged alive. The prevalence and consistency of β-blocker use were determined in patients with and without a history of myocardial infarction (MI). β-Blockers were always used in 1280 patients (50.9%) with and 1642 patients (48.1%) without previous MI after CABG. Compared with always users (n=2922, 49.3%), the risk of all-cause death was significantly higher among inconsistent β-blocker users (hazard ratio [HR], 1.96; 95% confidence interval [CI], 1.50-2.57), and never using β-blockers was associated with increased risk of both all-cause death (HR, 1.42; 95% CI, 1.01-2.00) and the composite of adverse cardiovascular events (HR, 1.29; 95% CI, 1.10-1.50). In the cohort without MI, the HR for all-cause death was 1.70 (95% CI, 1.17-2.48) in inconsistent users and 1.23 (95% CI, 0.76-1.99) in never users. In the MI cohort, mortality was higher for inconsistent users (HR, 2.14; 95% CI, 1.43-3.20) and ...
The Aim is to define the contribution of genetic variation to the interindividual variability in response to β-blockade. The rationale for the study is as follows: Beta-blockers prevent the activation of β-ARs and thus form the cornerstone of treatment of pathological states such as congestive heart failure and coronary artery disease. Functional polymorphisms in cardiac beta-receptors have been shown to determine response to β-blocker therapy. A physiologic stimulus such as exercise causes sympathetic stimulation and activation of the cardiac β-ARs and genotypic differences in response to β-blockers are magnified under states of heightened sympathetic activity. Thus, in addition to measuring the response to β-blockers at rest, we will also determine the response to β-blockade after sub-maximal exercise on a supine bicycle ergometer. Genetic variations that may alter sensitivity to a beta blocker will be sought ...
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Assumption: Precaution is needed when taking any medication during pregnancy. Beta-blockers for high blood pressure are included. TRUE Although beta-blockers taken during pregnancy can help lower blood pressure, babies whose mothers took beta-blockers grew more slowly than average babies. http://www2.cochrane.org/reviews/en/ab002863.html My Views: Of course, your care provider must help you weigh the benefits and risks…
This was a retrospective study, which means the data for it came from previously treated patients, but it was reasonably large (722 patients, of whom 155 were taking beta blockers). So, while this is solid evidence its not the same as a randomised clinical trial. There are lots of questions still to be explored, for example does the effect of beta blockers depend on prior exposure (i.e. do you have to have been taken them for a long time before diagnosis), is the effect still there if beta blockers are started after diagnosis, and at what dosage ...
First, before I forget, extreme nausea can be a symptom that heart failure is worsening. Personally, though, Id expect it to become progressively worse, not to come rampaging out of nowhere the way it did - I still suspect Nebivolol was the culprit. I will, however, bear it in mind and keep a close eye…
A new meta-analysis, one that excludes the largely discredited DECREASE studies conducted by disgraced researcher Dr Don Poldermans, suggests that beta-blocker use during noncardiac surgery is killing patients.
Ive been taking beta-blockers, propranolol and then atenolol, for palpitations for years. They dont make me dizzy, and don...
Limitations of the study included the lack of patients with milder forms of COPD airflow obstruction or exacerbation risk, and of course, the trials early end limiting the outcomes. Additionally, investigators had not enrolled patients with a proven indication of beta-blocker use or a prior history with the drug ...
A new study adds to doubts about using beta blockers to reduce the risks of surgery. The death rate for people given beta blockers before non-cardiac surgery wa
Beta blockers are used to treat certain types of heart-related problems. Learn about the benefits of using beta blockers from Discovery Health.
Nebivolol, (bystolic, nebilet, nebil) is a long acting cardioselective beta-blocker at present approved for the therapy of high blood pressure. Nebivolol is
beta blocker: A blocking agent, one of a class of drugs used to treat hypertension and control the rate at which the heart beats.
Beta-blockers (also known as beta-adrenoceptor blocking agents) are medications used to treat several conditions, often by decreasing heart activity.
The heart is a muscle that contracts in rhythmic sequence for the duration of our lifetime. Each beat is stimulated by an electrical signal that is ge...
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Objectives The purpose of this study was to compare the efficacy of beta-blockers in congenital long QT syndrome (LQTS). Background Beta-blockers are the mainstay in managing LQTS. Studies comparing the efficacy of commonly used beta-blockers are lacking, and clinicians generally assume they are equally effective.. Methods Electrocardiographic and clinical parameters of 382 LQT1/LQT2 patients initiated on propranolol (n = 134), metoprolol (n = 147), and nadolol (n = 101) were analyzed, excluding patients ,1 year of age at beta-blocker initiation. Symptoms before therapy and the first breakthrough cardiac events (BCEs) were documented.. Results Patients (56% female, 27% symptomatic, heart rate 76 +/- 16 beats/min, QTc 472 +/- 46 ms) were started on beta-blocker therapy at a median age of 14 years (interquartile range: 8 to 32 years). The QTc shortening with propranolol was significantly greater than with other beta-blockers in the total cohort and in the subset with QTc ,480 ms. None of the ...
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Purified sarcolemmal and light vesicle (intracellular) fractions of beta-adrenergic receptors were used to examine the effects of propranolol on receptor translocation in guinea pig heart. Guinea pigs were given propranolol (0.15 mg/kg/hr) via minipumps for 7 days and either killed or made ischemic for 1 hour via a coronary ligature. Propranolol treatment led to an externalization of beta-receptors from light vesicle to sarcolemmal fractions. This externalization increased the number of surface beta-adrenergic receptors that were functional, as assessed by isoproterenol-stimulated adenylate cyclase activity. After chronic propranolol treatment, ischemia did not further alter receptor distribution. These results suggest that externalization of beta-adrenergic receptors from a light vesicle fraction to the sarcolemma contributes to up-regulation of beta-receptors that occur in response to both propranolol treatment and ischemia. Because propranolol-treated animals show blunting in externalization ...
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Adrenergic beta-blocking agents were given to 7 patients with advanced congestive cardiomyopathy who had tachycardia at rest (98 plus or minus 13 beats/min). The patients were on beta-adrenergic receptor blockade for 2 to 12 months (average 5-4 months). One patient was given alprenolol 50 mg twice daily and the other patients were given practolol 50 to 400 mg twice daily. Virus infection had occurred in 6 of the patients before the onset of symptoms of cardiac disease. All patients were in a steady state or were progressively deteriorating at the start of beta-adrenergic receptor blockade. Conventional treatment with digitalis and diuretics was unaltered or reduced during treatment with beta-blocking agents. An improvement was seen in their clinical condition shortly after administration of the drugs. Continued treatment resulted in an increase in physical working capacity and a reduction of heart size. Noninvasive investigations including phonocardiogram, carotid pulse curve, apex cardiogram, ...
Beta blockers have been proven to have benefit in heart failure (HF) patients with regard to morbidity and mortality. However, initiation and uptitration remains a challenge in many patients. Worsening of heart failure, symptomatic hypotension and symptomatic bradycardia all limit up-titration to the target doses that have been shown to have mortality benefits (carvedilol [Coreg] 25 mg bid, metoprolol succinate [Toprol-XL] 200 mg qd) in the large clinical trials (COPERNICUS, MERIT-HF).. It is debated whether the benefit of beta-blockade is solely due to heart rate reduction or more broadly from the cardiac, central and peripheral effects of blocking sympathetic activity. Clearly, there is a remodeling effect on the dilated ventricle. Furthermore, patients with heart rates of 64 bpm or less are rarely begun on beta-blocker therapy. It is not known whether these patients should be given a pacemaker in order to then safely initiate beta-blocker therapy.. It is also clear that isolated right ...
Exercise training and beta-blocker treatment ameliorate age-dependent impairment of beta-adrenergic receptor signaling and enhance cardiac responsiveness to adrenergic stimulation. Am J Physiol Heart Circ Physiol 293: H1596-H1603, 2007. First published June 8, 2007; doi:10.1152/ajpheart.00308.2007.- Cardiac beta-adrenergic receptor (*-AR) signaling and left ventricular (LV) responses to beta-AR stimulation are impaired with aging. It is shown that exercise and beta-AR blockade have a favorable effect on cardiac and vascular *-AR signaling in several cardiovascular diseases. In the present study, we examined the effects of these two different strategies on *-AR dysregulation and LV inotropic reserve in the aging heart. Forty male Wistar-Kyoto aged rats were randomized to sedentary, exercise (12 wk treadmill training), metoprolol (250 mg kg-1 day-1 for 4 wk), and exercise plus metoprolol treatment protocols. Ten male Wistar- Kyoto sedentary young rats were also used as a control group. Old ...
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