New Heart Attack Guidelines Emphasize Medications

More heart attack survivors should use beta-blockers and ACE-inhibitors, and women "should not be prescribed estrogen solely to prevent strokes and heart disease," according to new prevention guidelines issued jointly by the American Heart Association and the American College of Cardiology. The AP/Arizona Daily Star reports that the recommendations, presented in today's issue of Circulation, are an update of 1995 guidelines and incorporate clinical trial research conducted since then. Beta blockers have been shown to "bloc[k] the body's response" to the excessive levels of "stress-related hormones that pour into the blood stream of heart failure patients," while ACE inhibitors expand blood vessels, helping to reduce stress on the heart. The guidelines also state that heart attack patients should be prescribed cholesterol-lowering drugs upon leaving the hospital, which currently happens only one-third of the time, according to Dr. Sidney Smith, the AHA's chief science officer. The estrogen guidelines were first announced by the AHA in July, and reflect recent research that suggests that hormone replacement therapy may increase the risk of heart trouble. The association is not recommending that women who use hormones for "non-cardiac benefits" stop taking them, but said they should "not start taking" them "simply to prevent heart trouble" (AP/Arizona Daily Star, 9/25).