- Women have historically been underrepresented in past clinical research, raising concerns about their use of beta blockers as a treatment for hypertension.
- Women with high blood pressure treated with beta blockers may have a higher risk of developing heart failure than men when they present to the hospital with acute coronary syndrome.
- More research is needed to determine the reasons why men and women react differently to beta blocker treatment.
Embargoed until 4 a.m. CT/5 a.m. ET Monday, July 13, 2020
DALLAS, July 13, 2020 — Women taking beta blockers for hypertension with no prior history of cardiovascular disease (CVD) have a nearly 5% higher risk for heart failure than men when they present to hospital with acute coronary syndrome, according to new research published today in Hypertension, an American Heart Association journal.
Beta blockers are medications that reduce high blood pressure and are prescribed for adults with hypertension, a leading cause of CVD. In this study, researchers analyzed the effects of beta blockers on men and women with hypertension and no history of CVD after presenting with acute coronary syndromes. Following incidence of heart failure was recorded to determine if the medication caused different outcomes depending on biological differences.
“Past research on the effects of beta blockers included a majority of participants who were men, so we sought to examine how sex/gender plays a role in the patient outcomes,” said Raffaele Bugiardini, M.D., professor of cardiology at the University of Bologna and lead author of the study. “Women are historically underrepresented in most clinical studies on hypertension. It’s important to include an equal split of male and female patients in future research, which could shed light on disparities and actionable treatments.”
The study analyzed information from the International Survey of Acute Coronary Syndromes (ISACS) Archives, the ISACS-TC and the EMMACE-3X clinical registries from October 2010 to July 2018. The research included data from 13,764 adults in 12 European countries who had hypertension and no prior history of cardiovascular disease. Patients were classified by sex/gender and then separated into two groups: those taking beta blockers and those who were not.
Researchers found that among the participants taking beta blockers:
- women had a 4.6% higher rate of heart failure than men when presenting to the hospital with acute coronary syndrome;
- the mortality of both men and women with heart failure was approximately seven times that of patients with acute myocardial infarction and no heart failure complications;
- women who had ST-segment elevation myocardial infarction (STEMI) were 6.1% more likely to have heart failure than men with STEMI, a serious form of heart attack in which a coronary artery is completely blocked and a large part of the heart muscle is unable to receive blood; and,
- men and women not taking beta blockers had approximately the same rate of heart failure.
“What we found presents a solid case for re-examination of the use of beta blocker therapy for women with hypertension. For women who have no history of cardiovascular disease and only hypertension, we think it is incredibly important for them to regulate their blood pressure through diet and exercise,” Bugiardini noted. “It’s possible that the increased risk of heart failure for women is due to an interaction between hormone replacement therapy and beta blockers, though this information was not collected or tested in our study. This and other potential factors need to be investigated in more depth.”
Researchers noted some limitations. Since the study was observational, results may have some variance and additional data is needed for confirmation. However, a randomized controlled trial of beta-blocker therapy in patients with hypertension may not be considered ethical since it would be designed to confirm risk and not benefit. The study did not include, nor have information for, the length of time patients used a previous treatment or dosing of beta blockers.
Through its signature women’s initiative, Go Red for Women®, the American Heart Association has advocated for increased representation of women in cardiovascular research studies for nearly two decades. Go Red for Women’s Research Goes Red empowers women to contribute to health research. The initiative has built a community of women scientists, researchers, and medical and health professionals to further raise awareness around women’s heart health by closing gender disparity gaps in research and clinical trials. In light of the COVID-19 pandemic, Research Goes Red expanded their reach and impact through a COVID-19 survey. This survey assesses the top concerns women have related to the health, social, economic and emotional impact COVID-19 has had on their lives.
Co-authors are Jinsung Yoon, Ph.D.; Sasko Kedev, M.D., Ph.D.; Goran Stankovic, M.D., Ph.D.; Zorana Vasiljevic, M.D., Ph.D.; Davor Miličić, M.D., Ph.D.; Olivia Manfrini, M.D.; Mihaela van der Schaar, Ph.D.; Chris P. Gale, M.D., Ph.D.; Lina Badimon, Ph.D.; and Edina Cenko, M.D., Ph.D.
No external funding sources are listed.
- Available multimedia is on right column of release link - https://newsroom.heart.org/news/women-taking-beta-blockers-for-hypertension-may-have-higher-risk-of-heart-failure-with-acute-coronary-syndrome?preview=012493d85bff492d43ba32c920556d97
- After Monday, July 13, view the manuscript online.
- ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction
- Research Goes Red
- Follow AHA/ASA news on Twitter @HeartNews
- Follow news from the AHA’s Hypertension journal @HyperAHA
Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https://www.heart.org/en/about-us/aha-financial-information.
About the American Heart Association
The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.
For Media Inquiries and AHA/ASA Expert Perspective: 214-706-1173
William Westmoreland: 214-706-1232, firstname.lastname@example.org
For Public Inquiries: 1-800-AHA-USA1 (242-8721)