Heart failure is a major—and growing—health problem in the United States. Millions of Americans suffer from this condition, and it adds billions to our nation’s healthcare costs each year. But you may not realize there’s more than one kind of heart failure—and some treatments that work for one type could potentially be dangerous for another.
Key Takeaways
- “Stiff heart” heart failure (HFpEF) is just as common as “weak heart” heart failure, but it is less understood.
- A University of Vermont study found that beta-blockers, a common heart failure medication, may actually make symptoms worse for many patients with HFpEF.
- Patients on beta-blockers for this specific type were found to be 74% more likely to be hospitalized for heart failure.
- Doctors and patients should carefully discuss medication choices, especially for “stiff heart” failure.
The Two Sides of Heart Failure: Not Just a Weak Heart
When most people think about heart failure, they imagine a heart that’s just not strong enough to pump blood. However, there’s a lesser-known type called “stiff heart” heart failure (or HFpEF), where the heart pumps normally but is too stiff to relax and fill properly. This form is just as common as the traditional “weak heart” kind, but it often flies under the radar—and it requires a different approach.
Beta-Blockers: Friend or Foe?
Beta-blockers are a mainstay for treating many heart conditions. For people with “weak heart” failure, they’re lifesaving—reducing symptoms, hospitalizations, and the risk of early death. But when it comes to HFpEF, the evidence just isn’t as clear. Because few proven medications exist for “stiff heart” failure, doctors often rely on beta-blockers even though their benefits aren’t well established for this group.
Troubling Findings from a Major Study
A research team at the University of Vermont took a closer look at how beta-blockers affect people with HFpEF. They analyzed data from a large clinical trial called TOPCAT, which included many patients with this type of heart failure. Astonishingly, they found that people on beta-blockers were 74% more likely to end up in the hospital for heart failure than those not taking the drug. These findings suggest the treatment might not just be unhelpful—it could actually be making things worse.
Why Might Beta-Blockers Backfire?
Unlike in “weak heart” failure, where beta-blockers help the heart do less work, in “stiff heart” failure these drugs might increase pressure inside the heart. That can worsen symptoms like fluid retention and make it harder to breathe—two issues that are already challenging for people coping with HFpEF. The study proposes that a one-size-fits-all approach to heart failure medication doesn’t work for everyone.
What Should Patients and Caregivers Do?
If you or someone you love has been diagnosed with “stiff heart” failure, it’s worth having a conversation with your doctor about what medications you take and why. Ask whether your treatment plan is based on strong evidence for your specific condition. You deserve a personalized approach to care—one grounded in the latest scientific findings.
Why This Research Matters
Led by Dr. Timothy Plante, the study’s authors hope their work will shine a spotlight on the need for more research and better treatment options for HFpEF. Right now, people with this kind of heart failure don’t have as many proven choices, and more attention—and more studies—will hopefully lead to safer, more effective care.
Conclusion
The debate over beta-blocker use in “stiff heart” heart failure is far from over, but this new research could change the way doctors handle this challenging diagnosis. If you or a family member live with heart failure, keeping the conversation open with your healthcare provider is your best tool for safer, more effective treatment.
Scientific References
- Plante, T.B., et al. (2024). “Beta-Blocker Use in Heart Failure With Preserved Ejection Fraction: Findings From TOPCAT.” JAMA Network Open. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2816789
- American Heart Association – What is Heart Failure? https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure