Beta blockers seem to unclog arteries

Beta-blocker therapy significantly decreases coronary atherosclerosis in patients with heart disease, according to a new study.

Cleveland Clinic investigators reviewed four trials that utilized intravascular ultrasonography to measure atheroma volume. The analysis included 1,515 patients, all with coronary artery disease for 18-24 months. Of those, 1,154 patients received beta blockers.

Atheroma volume decreased annually by 2.4 ± 0.5 mm³ for patients treated with beta blockers while remaining unchanged for untreated patients. Results were adjusted for history of hypertension, angina, or MI.

Previous trials have shown that “beta blockers effectively reduce recurrent myocardial infarction, sudden cardiac death, and total mortality in patients with myocardial infarction,” according to the investigators (Ann Intern Med. 2007;147:10-18). However, this analysis stands as the first to demonstrate that beta blockers can slow the progression of coronary atherosclerosis.

Reducing plaque is one thing, but improving outcomes is another. And researchers were quick to point out that “no direct data exist about the amount of differential change in atheroma volume that is associated with better clinical outcomes.” Even so, beta blockers have “considerable coronary antiatherosclerotic effects,” wrote the investigators, and “our findings provide contemporary evidence that supports the use of beta blockers for treating coronary artery disease.”