Tuesday, February 21, 2006

A smooth landing into a diagnosis of heart disease

Taking prescription beta blocker 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, U.S. researchers reported on Monday.

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.

"Having a heart attack causes permanent damage, even if it doesn't kill you," he added.

Among 916 patients whose first heart disease symptom was a heart attack, 20 percent were taking statins. In a group of 468 patients with chest pain, 40 percent took statins.

Nineteen percent of heart attack patients were on beta blockers, compared with 48 percent of those with chest pain.

Because the study was not prospective, it lacked information on confounding factors such as the use of aspirin therapy to prevent coronary heart disease," Dr. Smith added. "If aspirin therapy was strongly associated with the use of statins and beta-blockers, it could explain some of the effect of these two drugs."

"Although our findings must be confirmed by randomized studies, they suggest that use of statins and beta-blockers for primary prevention may not only reduce the incidence of coronary artery disease but may also increase the likelihood of more stable, lower-risk clinical presentation of coronary atherosclerosis," the authors concluded.

This is a terrific study. I applaud the study authors for looking over patient records and drawing the potential lifesaving conclusions that came from this analysis. We all fear that out-of-the-blue heart attack and wonder if we should be paying attention to every little chest discomfort, arm or neck pain, shortness-of-breath issue. This can create such anxiety. Perhaps these two classes of drugs will allow symptoms of heart disease to be more readily apparent through a classic clinical presentation of increasing symptomatic warnings with activity which allows a thorough workup without the danger of a sudden change in clinical status.

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