beta blockers and anticoagulants

[OldJane]

Medscape posted a long article about a research on beta blockers and how few RCTs have been done on their efficacy for AF. It was hard to interpret but seems that for some folk they make AF worse and for many the side effects are too negative. There’s also an article on over prescribing of anticoagulants - if your blood pressure is just high enough to push up your CHADs score you are advised to take them but may really not need them. Seems more and more research interest is being taken on the routine approaches to AF. That has to be good. Certainly my EP thought beta blockers - Bisoprolol - counter indicated for me.

[Desanthony]

Beta blockers were a no go for me - tried a few and calcium channel blockers and a mixture for about 9 months to a year but made me feel worse than the Afib. As the anticoagulants seem to have no effect on me I am quite happy to keep taking them until told otherwise. I am just over 80 with permanent low rate Afib and just take the anticoagulants some urology medication and painkillers for a bad back and neck. I have a feeling that I may be given a reduced dose of my anticoagulant now that I am over 80 have an appointment in a few weeks time so will find out then.

[pusillanimous in reply to Desanthony]

Yes, I think, certainly with Eliquis, if you are over 80 and under 60kg you are changed to 2.5mg twice a day - I was !!!

[terryw in reply to pusillanimous]

I am over 80 and raised the question of reducing my Apixban dose with my GP. I was advised that it was not necessary, because the blood tests on my liver were satisfactory.

[pusillanimous in reply to terryw]

Interesting because the package insert is quite clear, are you perhaps heavier that 60kg, and it seems more concerned with your creatinine (kidneys) than liver.? I would read the package insert and discuss it with your pharmacist - he's the one who has had 3 years training in pharmacology?

[terryw in reply to pusillanimous]

Perfectly formed! My mistake it was kidneys I think. I am due my annual blood tests in December so I will raise it again. I will also speak to a Cardiologist next time I see one. Thanks for reminding me and getting me to challenge the medical profession again.

[terryw in reply to pusillanimous]

Hi. Just had a look at the NHS advice on Apixaban. It reads, ' Your doctor may prescribe a lower dose of one 2.5mg tablet twice a day if you're over 80 years old, weigh less than 60kg (9st 6lb), or have kidney disease and are at higher risk of bleeding'. I only suffer from being over80! The only time I seem to bleed a lot is with tooth extraction.TerryW

[Desanthony in reply to terryw]

Seeing my Dr at last, after having 3 appointments cancelled, tomorrow morning. It is at 11am so am hoping if they are going to cancel again I will have already left the house (without mobile) and not know they are cancelling - my wife says if they do cancel then she is going to tell them she is sending me to the surgery and I am to sit there until I get the result. I should have got the result on 10th October but cancelled because the Dr who organised the blood tests wasn't available. So 10 days later I had an appointment with him which was cancelled as he wasn't available but offered an appointment later the same day with a locum (??) On the day of that appointment the locum had Covid - annoyed because we were due to go away that day and had postponed it. so come hell or high water I am going to get those results tomorrow! We don't have access to NHS app in Wales which is also very annoying.

[mav7]

Could you post a link to the Medscape article ?

[OldJane in reply to mav7]

academic.oup.com/europace/a...

[mav7]

Great article. Thx for posting. Lengthy, will need time to review.

[Silky57]

Thanks for posting this. Definitely food for thought. It appears Bisoprolol shouldn’t be the first line of treatment.

[Nezzera]

We can add Sotalol to that too which I am due to discontinue next week. End of blanking period.

Good article, describes my situation exactly.

Thank you for the heads up.