Beta-blockers are medications that lower high blood pressure and are prescribed for adults with hypertension, a leading cause of heart disease. In a study published in Hypertension, researchers from the University of Bologna found that women taking beta-blockers for high blood pressure have nearly a 5% higher risk of heart failure than men when they present to hospitals with acute coronary syndrome.
Researchers analyzed the effects of beta-blockers on men and women with hypertension who had no history of heart disease and were admitted with acute coronary syndromes. The incidence of heart failure was then recorded to determine whether the medication led to different outcomes depending on sex or gender.
“Past research on the effects of beta-blockers included a majority of participants who were men, so we sought to examine how sex and gender play a role in 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 is important to include an equal proportion of male and female patients in future research, which could shed light on disparities and guide more effective treatments.”
The study analyzed data from 13,764 adults in 12 European countries who had hypertension and no prior history of cardiovascular disease. Patients were classified by sex or gender and then divided into two groups: those taking beta-blockers and those who were not.
Researchers found that among participants taking beta-blockers:
Women had a 4.6% higher rate of heart failure than men when admitted with acute coronary syndrome;
The mortality rate for both men and women with heart failure was approximately seven times higher than that of patients with acute myocardial infarction without heart failure complications;
Women with ST-segment elevation myocardial infarction (STEMI) were 6.1% more likely to develop heart failure than men with STEMI, a severe form of heart attack in which a coronary artery is completely blocked and a large portion of the heart muscle cannot receive blood;
Men and women not taking beta-blockers had approximately the same rate of heart failure.
“What we found presents a strong case for re-examining the use of beta-blocker therapy in women with hypertension. For women with no history of cardiovascular disease and only hypertension, it is especially important to manage blood pressure through diet and exercise,” Bugiardini noted.
“It is possible that the increased risk of heart failure in women is due to an interaction between hormone replacement therapy and beta-blockers, although this information was not collected or tested in our study.”
Researchers also noted some limitations. Since the study was observational, the results may vary, 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, as it would be designed to confirm risk rather than provide benefit.
