Beta-Blockers after Myocardial Infarction: Do Benefits Ever Outweigh Risks in Asthma?

• Published in: Cardiology Vol. 92; no. 2; pp. 99 - 105
• Main Authors: Chafin, Carol C., Soberman, Judith E., Demirkan, Kutay, Self, Timothy
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.1999; S. Karger AG
• Subjects: Adrenergic beta-1 Receptor Antagonists; Adrenergic beta-Antagonists - adverse effects; Adrenergic beta-Antagonists - therapeutic use; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Asthma - complications; Asthma - genetics; Biological and medical sciences; Bronchial Spasm - chemically induced; Bronchial Spasm - drug therapy; Bronchial Spasm - prevention & control; Bronchodilator Agents - therapeutic use; Cardiovascular system; Humans; Hypolipidemic Agents - therapeutic use; Medical sciences; Miscellaneous; Myocardial Infarction - complications; Myocardial Infarction - drug therapy; Pharmacology. Drug treatments; Polymorphism, Genetic; Randomized Controlled Trials as Topic; Review; Risk Assessment; Myocardial infarction; β-Blockers; Asthma; Human; Infarct; Respiratory disease; Toxicity; Treatment efficiency; Cardiovascular disease; Coronary heart disease; Myocardial disease; β-Adrenergic receptor; Concomitant disease; Chemotherapy; Treatment; Myocardium; Obstructive pulmonary disease; Antagonist; Bibliographic review; Beta blocking agent
• ISSN: 0008-6312; 1421-9751
• DOI: 10.1159/000006955

β-Blockers are well documented to prolong life in patients after myocardial infarction (MI), yet patients who also have asthma are frequently and understandably denied this therapy. We reviewed the literature (via MEDLINE) for the past 35 years for β-blocker-induced asthma, and reexamined potential β-blocker use in the context of NIH guidelines for asthma classification and management. Because β-blockers can cause fatal or life-threatening asthma, their use should be avoided in moderate to severe persistent asthmatics. Benefits of low-dose β 1 -blockers (e.g. atenolol 50 mg daily) may outweigh risks in some patients with mild intermittent or well-controlled mild persistent asthma. Further study is needed to verify that low doses of β 1 -blockers are effective in prolonging life after MI, and that use specifically in mild intermittent or mild persistent asthma per NIH classification is safe.