Can Beta Blockers prevent further problems with aortic dilation?

[tigerlily]

My cardio recently recommended that I come off my beta blocker until I told him that my surgeon thought it would be a good idea if I continued the metoprolol. His reason was that the beta blocker would help prevent future enlargements of my aortic wall. I had my aortic valve replaced and my aortic root repaired nine weeks ago. The surgeon also had said that my tissue appeared healthy so I think he is just being conservative. Has anyone ever heard of this? I would like to come off of the beta blocker if possible because it may be one of the reasons I'm so tired at this point.

 

[Ross]

The only one that has been studied and they feel would be of benefit is Cozaar. There was no mention of any others that I know of. I can tell you, it didn't do a thing for mine, it kept right on growing.

 

[tobagotwo]

Oversimplified, beta blockers tend to make the heart beat less often and less hard. From that standpoint, there is a logical aspect to the statement. However, it is a great (and unproven) leap to say that it would prevent or even slow expansion of the root or aortic wall, such as with aneurysms.

Even Cozaar, which has been linked to a reduction and even healing of aneurysms in mice genetically altered to mimic Marfans, hasn't panned out in humans as many expected.

Sharp control of high blood pressure is sometimes used as a method for lowering the incidence of type III aneurysms, but usually in the case of someone with difficult hypertension. If your blood pressure is such that your doctor or cardiologist is suggesting you go off of it, I would follow their advice. A cardiologist deals with patients long term, and has much more opportunity to observe the values of drugs he administers. A surgeon walks in and out of your life, hopefully leaving you with a little more time in his wake.

An expanded aortic root that has been well-stabilized should last a very long time, frequently a lifetime. And it certainly isn't in the league of a type III aneurysm or the problems that can go along with Marfans.

Best wishes,

 

[CCRN]

Beta Blockers

Beta Blockers

I came off Toprol about 4 months post op because I just couldn't take the fluid retention any more. My surgeon wanted me to stay on it in order to "preserve the valve" and I asked him "What is there to preserving a mechanical valve?". He didn't have an answer to that. I think it's believed to be a safety net by some docs. Of course, it is necessary for a few months post op for recovery purposes, remodeling, and hypertension issues. I didn't have any of those issues and my blood pressure was so low I was having dizzyness.

My cardiologist revisted the issue earlier this year as I had the aneurysm that MIGHT me associated with bicuspid valve connective tissue disorder. If that is the case, a beta blocker would be indicated. I wanted to rule the diagnosis in or out before I went back on the med so he ordered a MRA of my head a couple of months ago and I'm to have my aorta re-evaluated this June a year out from surgery with contrast CT. If it's negative as well I'll be free without any question. If I had a tissue valve I would be stuck with the drug for "presevation" issues. If I had to make the choice between coumadin and a beta blocker, I'll take coumadin any time and I'm glad to be on it.

As you can see, beta blockers are prescribed for many different reasons. Many post op valvers are taking them and many are not. Ask your doc what his reason is for staying or going off the drug and see what rational he/she gives. Hope this helps.

 

[jax3172]

Beta Blocker

Beta Blocker

Had valve job and ascending aorta repair 7/21/05. I was on a beta blocker for a short time in October/November. I fought it and stopped taking the drug. I am now back on Atenolol 12.5 mg/day. It's a very tiny dose but it has done wonders for my heart rate. Pre-Atenolol, as I type this, my rate would have been about 90, now it's 70. I'm not one for drugs, but I gotta believe the plumbing is better off with the beta blocker. Interestingly enough, my O2 levels are and were sky high, and my EF with the new valve is like 68%. Left to its own devices, why does my stupid heart think it has to beat so often??? One of life's mysteries, I guess. A year ago (pre-surgery) and all my life, my resting HR ws about 55 or 60. But small dose beta blockers get my vote - just watch your BP closely.