July 17, 2002
Underuse of beta-blockers because of conventional wisdom about significant adverse effects may be unjustified, according to a review of 15 randomized trials reported in the July 17 issue of The Journal of the American Medical Association.
Although beta-blockers did not increase the risk of depression, there was a small increase in risk of fatigue and sexual dysfunction.
“Given the survival benefits associated with beta-blocker therapy, concerns about the development of these adverse effects should not deter physicians from initiating long-term treatment when indicated, although surveillance for adverse effects remains prudent,” write Dennis T. Ko, MD, from the Yale University School of Medicine in New Haven, Connecticut, and colleagues.
In this quantitative review, Ko’s group searched the medical literature for trials of beta-blockers in myocardial infarction, heart failure, and hypertension, and they found 42 trials that were placebo-controlled, randomized, noncrossover design, and enrolled at least 100 subjects who were followed for at least six months.
Studies that did not report information on depressive symptoms, fatigue, and sexual dysfunction were excluded, resulting in 15 trials involving more than 35,000 subjects.
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