Taking prescription beta blockers or statin drugs may boost the chances of having only mild chest pain instead of a heart attack as the first symptom of heart disease, researchers reported Monday.
The scientists studied 1,400 patients newly diagnosed with heart disease to try to pinpoint why some had a heart attack while others experienced chest pain known as exercise-induced angina, which is far less dangerous.
Twice as many of the chest pain patients had filled prescriptions for a beta blocker or a statin during the previous five months, they found.
Previous studies had shown those types of drugs cut heart disease risk overall, but the new research is the first to demonstrate they may reduce the chances of someone having a sudden heart attack without earlier symptoms.
“If there are warning symptoms like angina with exercise, there is enough time to see a doctor and get started on effective treatments that reduce risk,” said Mark Hlatky, one of the study’s authors and a professor of cardiovascular medicine at Stanford University in California.
“Having a heart attack causes permanent damage, even if it doesn't kill you,” he added.
Heart disease is the leading killer of Americans. Some studies have shown that gay people, particularly lesbians, may be at a higher risk of heart disease than their heterosexual peers. Gay men and lesbians are significantly more likely to smoke than heterosexuals, putting them at risk for heart disease, says Kathleen DeBold, executive director of the Mautner Project, a national lesbian health organization. According to clinical research, lesbians tend to have a higher body mass index than nonlesbians, which increases the risk of heart disease and stroke, DeBold adds.
Statins, which reduce artery-clogging cholesterol, include Pfizer’s Lipitor, Merck’s Zocor, and Bristol-Myers Squibb’s Pravachol.
Beta blockers, prescribed to lower high blood pressure, include GlaxoSmithKline’s Coreg and several generic drugs such as sotalol.
The study involved patients enrolled in a Kaiser Permanente health insurance plan in Northern California. The men were between ages 45 to 74, and the women were age 55 to 74.
Among 916 patients whose first heart disease symptom was a heart attack, 20% were taking statins. In a group of 468 patients with chest pain, 40% took statins.
Nineteen percent of heart attack patients were on beta blockers, compared with 48% of those with chest pain.
Researchers also reviewed use of hormone therapy for women and drugs called alpha blockers, ACE inhibitors, and angiotensin II receptor blockers among both genders.
“We looked at all the medications used to prevent heart disease, but only statins and beta blockers lowered the risk of heart attack,” said Alan Go, the study’s lead author and a researcher at Kaiser Permanente of Northern California.
The researchers said more study was needed to confirm their findings. The health records did not specify in all cases whether patients were taking aspirin, which also protects the heart and could have influenced cardiac outcomes, they said.
Side effects of statins may include liver or muscle problems. Beta blockers can lower blood pressure and slow the heart rate, causing fatigue, Go said.
The study, published in the Annals of Internal Medicine, was conducted by Kaiser and Stanford researchers as well as scientists at the University of California, San Francisco.
It was funded by the Donald W. Reynolds Foundation, a Las Vegas–based philanthropic group that provides grants for medical research and other programs. (Reuters, with additional reporting by Advocate.com)
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