Beta-blocker therapy did not affect physical activity levels over 18 months in post-MI patients without heart failure, with similar cardiac rehab participation (43.6% vs 42.3%).
RCT (n=2,867)
open-label
randomized
Yes
Does long-term beta-blocker therapy reduce physical activity levels in post-MI patients without heart failure?
Long-term beta-blocker therapy does not negatively impact self-reported physical activity levels over 18 months in post-MI patients without heart failure.
Abstract Introduction The BETAMI-DANBLOCK trial recently found that beta-blockers reduced the risk of all-cause death or major adverse cardiovascular events in patients with a recent myocardial infarction (MI) without heart failure symptoms and left ventricular ejection fraction ≥40%. Some observational data and small intervention studies indicate a possible negative relationship between beta-blocker therapy and physical activity (PA) levels. However, it is still unclear how beta-blocker treatment influences PA after an acute MI. Purpose To investigate the effect of long-term beta-blocker therapy on PA level after MI in patients without heart failure. Method In this post-hoc analysis of the multicentre, randomized, open-label BETAMI trial with blinded endpoint evaluation, patients hospitalized with a MI and without heart failure were assigned to beta-blocker therapy within seven days after the event or no beta-blocker therapy. PA levels were assessed prior to randomization and at 1-, 6-, 12- and 18-months follow-up by self-reported questionnaires. The main endpoints were between-group changes in hours/week of light- (e.g., walking, dancing, cycling) and vigorous PA (e.g., brisk uphill walking, running) from baseline to 18 months, estimated by linear mixed models. Additionally, we assessed between-group differences in the proportion with guideline-recommended PA level (≥30 minutes of moderate activity on ≥5 days/week) and the participation rates in cardiac rehabilitation or organized PA programs. Results Of the 2867 patients, 2148 (75%) responded to the questions regarding PA in the follow-up period. Median age was 62 (IQR 55-70) years, and 19.6% were women. The median beta-blocker dose in the intervention arm was equivalent to metoprolol depot 50 mg/day. No differences in mean hours of light and vigorous physical activity were reported between the beta-blocker and non-beta-blocker groups at baseline, and these remained comparable throughout the 18 months follow-up (Figure 1). At baseline 31.2% met the guideline-recommended level of PA. This proportion increased to 39.2% at 6 months, with no significant differences between treatment arms at any time point (Figure 2). We found no effect of beta-blocker dose on the PA level. Participation in cardiac rehabilitation or organized PA at 12 months follow-up was 43.6% in the beta-blocker group and 42.3% in the non-beta-blocker group. Conclusions Beta-blocker therapy did not affect the PA level in post-MI patients without heart failure during 18 months follow-up.For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text.
Sverre et al. (Mon,) conducted a rct in myocardial infarction without heart failure (n=2,867). Beta-blocker therapy vs. No beta-blocker therapy was evaluated on Between-group changes in hours/week of light and vigorous physical activity from baseline to 18 months. Beta-blocker therapy did not affect physical activity levels over 18 months in post-MI patients without heart failure, with similar cardiac rehab participation (43.6% vs 42.3%).