Heart patients miss out on medication

By MARTIN JOHNSTON, health reporter

Thousands of people living with heart failure are missing out on the potential benefits of a class of drugs found to help the condition.

Beta-blockers were once avoided in heart failure because of the risk of aggravating it, but trials about five years ago showed that they could help many patients. The drugs are also used to treat angina and high blood pressure.

The National Heart Foundation wrote guidelines approving the use of the beta-blockers for heart failure patients in 2001.

But heart specialists say more patients should be taking them. Not only would they live longer, more productive lives, but the health system would save money through fewer admissions to hospital.

"I think the number of heart failure patients on beta-blockers is almost certainly too low," a Green Lane Hospital cardiologist, Dr Ralph Stewart, said yesterday.

A beta-blocker maker, Roche Pharmaceuticals, says sales data and prescriber surveys by a health statistics company estimate that only 7 per cent of New Zealand's 40,000 to 80,000 heart failure sufferers are using one of the drugs.

Roche says half of people with heart failure die within three to five years of diagnosis.

The condition's main causes are heart attacks or high blood pressure. Its main symptoms are breathlessness and swollen legs.

In trials that followed heart failure patients for more than a year, beta-blockers were found to reduce the death rate by about 30 per cent.

A Middlemore Hospital cardiologist, Dr Mayanna Lund, said although about 20 per cent of heart failure patients would be unable to take beta-blockers because they had conditions including asthma, many more people could benefit from them.

She said the message about them was taking time to be widely accepted.

Dr Lund said cardiologists ran training sessions for GPs on the use of beta-blockers.

Heart Foundation spokeswoman Dr Kristin Good, a GP, said the usage was probably higher than 7 per cent but still too low. Many GPs had been taught not to use the drugs for heart failure, and retraining was needed.

Beta-blockers

* The body uses the message hormones adrenaline and noradrenaline to control heart rate and blood pressure.

* They do this by attaching to "beta receptors" in heart tissue.

* Beta-blocker drugs interfere with this by attaching to the receptors in place of the hormones, reducing heart rate and blood pressure.