Read through the search results on asthma and beta blockers, and the news seems to be all doom and gloom. If you don't dig deeper, you'd be forgiven for thinking that asthma sufferers should not take this cardiac medication. Yet with further research, the picture becomes a little less clear cut. You see, fortunately for those with conditions that are classified as 'Reactive Airway Diseases', advances in medical technology and drug research have benefited heart health too. Not only that, but new studies have questioned whether any cardiac patients - asthma sufferers or not - really benefit from beta blockers anyway. This article will look at these points, as well as what alternatives are available.
Beta blockers (also called Beta-adrenergic blocking agents) are used for:
* high blood pressure
* migraine prevention
* angina (pain originating from the heart muscle)
* irregular and fast heartbeats (treatment and prevention)
* the symptoms of an overactive thyroid gland
* congestive heart failure
* preventing performance anxiety in musicians and others
* a number of other conditions.
They work by blocking the effect of the hormone adrenaline, as well as chemicals related to it that are also associated with this 'fight or flight' mechanism. These drugs actually come in two classes. Old style medications are called non-selective beta blockers. Newer ones are known as cardio selective beta blockers. The difference between them relates to the fact that the older class of drugs block two of the three types of beta receptors in the body (1 and 2, located in the heart, as well as the lungs, gastrointestinal tract, liver, uterus and other areas). The newer drugs are more precise. They can block either beta receptor 1 or 2 - hence the name.
This is good news for asthma sufferers, as evidence exists that cardio selective beta blockers are actually safe for asthmatics and those with certain other serious respiratory problems. The problem with the older style of drug was that it had the potential to cause severe asthma attacks. The risks were just not worth it, so people were rarely put on them.
The new drugs don't pose such a threat, however, at least for those with mild to moderate asthma. This change of medical opinion came about after an analysis of a number of published studies, after they had been qualified as eligible to be considered. It is important to note, however, that long term use is still not suggested for asthma patients. And in the case of severe asthma, beta blockers are still contraindicated.
One very interesting report in Science Daily threatens to throw the whole issue out the window. They cite a Cochrane Review of 13 randomized trials that altogether had more than 91, 000 people in them. The Review analyzed whether the studies involved found beta blockers effective in controlling the progression of heart disease, or preventing death from it. And they found that it was not significantly better than a placebo at either. The beta blocker used was called atenolol, which is a cardioselective beta blocker that has an affinity for beta receptor 1.
Whilst the Science Daily article points out that more work needs to be done before this information is extrapolated across the board to all beta blockers, they also note that the chief cardiac alternatives fared better. These include calcium channel blockers, thiazides, and renin-angiotensin system inhibitors.
This is all good news for asthma sufferers with cardiac problems. It means that there are classes of drugs available to them that are safer for their airways, and more likely to actually protect them from the problems associated with heart disease. As always, discuss your options with your doctor, and if you're not happy with the results, get a second opinion.
References:
1. Medscape
2. MayoClinic
3. American Academy Of Family Physicians
4. Cochrane Reviews
5. Wikipedia
6. Science Daily
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