BBC doctor's beta blocker warning over 'higher risk' and side effects

BBC doctor's beta blocker warning over 'higher risk' and side effects Drug prescribed 50 million times a year in UK and BBC Morning Live viewers told of how they 'may not be universally helpful' A BBC doctor has spoken out after a recent study gave a warning to some heart attack patients who are taking them - and said it showed a higher risk of death in the longer term. Dr Ranj Singh said the recent research suggested people taking the drug after mild heart attacks might not need them. And he explained to BBC Morning Live viewers that the side effects can have a big impact, giving tiredness and fatigue and sapping energy levels. Host Helen Skelton asked: “More than 50 million prescriptions are issued in the UK every year for beta blockers. “They are incredibly common. New research though claims it could challenge 40 years of thinking about how effective these tablets really are. Dr. Ranj, what what is this study going to mean to people? Because as we’ve said, they're so common loads of people use them.” Dr Ranj said: “There are very commonly used medications used in a range of different conditions ranging from after a heart attack or people with heart failure through to certain types of heart valve disease, irregular heart rhythms, angina and high blood pressure. Although we don’t tend to use them first line in uncomplicated high blood pressure anymore. "They work by blocking the effects of the hormones adrenaline and noradrenaline, the stress sort of, you know, fight or flight hormones that we have in our body. They work by blocking beta receptors. And you find these receptors throughout your body. You’ll find them in your heart, in your blood vessels, even in your lungs and pancreas, etc. "And what they do, they work by calming things down. So, when you give someone a beta blocker, it brings their heart rate down, it brings their blood pressure down, it brings down the amount of work that the heart has to do and it reduces the heart's oxygen requirement.” He said that they are usually used with great benefit when a person has had a heart attack and allows it to recover. He explained: “That’s why we give people them routinely. We used to give them beta blockers because they were felt to be helpful. Now, the most recent research, which has come from a study of over 8,500 patients in Spain and Italy, alongside some other studies, has basically questioned that thinking, that actually they may not be universally helpful for everyone. “The bottom line is that if you’ve had an uncomplicated heart attack and your heart function is still relatively well preserved then actually you may not benefit from a lifelong beta blocker afterwards which is what we used to do and that’s where the thinking is changing.” Dr Ranj said that due to the evidence in the study guidelines are ‘starting to shift’ as a result. He added: “What we used to do is give them to everybody and now what we’re doing them is starting them and then reviewing after a year to specifically ideally target those who are going to benefit the most. ”But remember this is a study that only looks at patients who have had a heart attack and beta blocker use in them. Another little thing to note here in these patients was they did a subgroup analysis of some of these patients and they found that women who were on beta blockers were on a slight were at a slightly higher risk of death long term. “But I want to urge a word of caution here. It’s a subgroup analysis. These are notoriously unreliable. But what it does mean is that more research is needed to look at that before we draw any firm conclusions. “ Side effects are one reason people could want to come off beta blockers, he said: “They do have potentially significant side effects. The big one is tiredness and fatigue. Lots of people report that when they’ve been starting on beta blockers feels like their energy levels just slump. Other things people report are dizziness, cold hands and feet, which could be an issue if you’ve got something like Raynaud’s. Sleep disturbance and even sexual dysfunction, things like erectile dysfunction in men.” But he warned people to not stop them suddenly: “You can have this rebound effect where your body becomes very sensitive to the effects of adrenaline. So what happens when if you stop your beta box abruptly, your heart rate might shoot up, your blood pressure might shoot up, you may get palpitations and chest pain. We don’t recommend people do that. Discuss it with a health care professional or your GP because you’re probably going to need to titrate them down gradually.”