For years, beta blockers have been a standard treatment for all heart attack patients, helping to reduce the heart’s workload by blocking the effects of adrenaline. However, new research challenges the necessity of this heart medicine for survivors who don’t suffer from heart failure. A Swedish study from earlier this year showed that beta blockers have no significant life-saving benefit for these patients. Now, a sub-study from Uppsala University raises further concerns, suggesting that beta blockers could increase the risk of depression for these individuals.
BETA BLOCKERS AND DEPRESSION SYMPTOMS
The study, led by Philip Leissner, a doctoral student in cardiac psychology, highlights a concerning side effect of beta blockers: depression. The sub-study followed 806 patients who had experienced a heart attack but had normal heart function. Of these patients, half were given beta blockers, while the other half were not. Researchers found that those who received beta blockers showed slightly higher levels of depression symptoms compared to those who did not.
“We found that beta blockers led to slightly higher levels of depression symptoms in patients who had had a heart attack but were not suffering from heart failure,” says Leissner. “At the same time, beta blockers have no life-sustaining function for this group of patients.”
RISKS OF BETA BLOCKERS IN HEART ATTACK SURVIVORS
Beta blockers work by blocking the effects of adrenaline, which helps reduce heart rate and blood pressure. While these drugs have long been considered essential for heart attack recovery, new research has raised questions about their efficacy, especially for patients with no heart failure. A major study earlier this year found that beta blockers did not protect against relapse or death compared to patients who did not receive the drug.
Leissner and his colleagues focused their research on the psychological effects of beta blockers, exploring their potential link to anxiety, depression, and sleep disturbances. Previous clinical experience and older studies have suggested that beta blockers could contribute to mood disorders, including difficulty sleeping and nightmares.
SUB-STUDY: EXPLORING DEPRESSION IN NON-HEART FAILURE PATIENTS
Between 2018 and 2023, Leissner’s team conducted the sub-study with 806 patients who had survived a heart attack but did not have heart failure. Of those, 100 patients had been on beta blockers before the study began. The team found that the patients receiving beta blockers experienced more severe symptoms of depression compared to those who did not receive the medication.
Leissner points out that while doctors historically prescribed beta blockers to all heart attack patients, including those without heart failure, the growing body of evidence against their necessity for these patients should prompt a reevaluation of this practice.
“If the drug doesn’t make a difference to their heart, then they are taking it unnecessarily and at risk of becoming depressed,” says Leissner.
RECONSIDERING TREATMENT FOR HEART ATTACK PATIENTS WITHOUT HEART FAILURE
Given the emerging evidence against the routine use of beta blockers in heart attack patients with normal heart function, medical professionals are urged to reconsider their use in these cases. While beta blockers are effective for patients with heart failure or other heart conditions, the risks for depression in those without these issues may outweigh the benefits.
