{"id":"17380bfdebca","type":"article","url":"https://hartvaat.nl/2025/08/01/reduce-ami-betablokker-interruptie-en-bloeddruk-hartfrequentie-effecten-na-mi/","title":"REDUCE-AMI: bètablokker-interruptie en bloeddruk/hartfrequentie-effecten na MI","title_en":"Beta-blocker interruption effects on blood pressure and heart rate after myocardial infarction: the AβYSS trial.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts"],"tags":["betablokkers","bisoprolol","bloeddrukbehandeling"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehaf170","source_url":"https://doi.org/10.1093/eurheartj/ehaf170","authors":["Niki Procopi","Michel Zeitouni","Mathieu Kerneis","Guillaume Cayla","Emile Ferrari","Grégoire Range","Etienne Puymirat","Nicolas Delarche","Paul Guedeney","Farzin Beygui","Laurent Desprets","Jean-Louis Georges","Thomas Bochaton","François Schiele","Grégory Ducrocq","Marie Hauguel-Moreau","Raphaelle Dumaine","Michel S Slama","Laurent Payot","Mohamad El Kasty","Karim Aacha","Abdourahmane Diallo","Xavier Girerd","Eric Vicaut","Johanne Silvain","Gilles Montalescot"],"significance":6,"published":"2025-08-01","source_date":"2025-08-01","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/betablokkers-farmacologie/","https://hartvaat.nl/kennis/farmacologie/antiaritmica-farmacologie/"],"congress":"","summary_en":"This ABYSS subanalysis showed that beta-blocker interruption after MI leads to modest increases in blood pressure and heart rate that remain clinically acceptable, providing hemodynamic reassurance for the discontinuation strategy.","created":"2026-07-03T10:31:46Z","updated":"2026-07-03T13:30:46Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"REDUCE-AMI subanalyse onderzocht de hemodynamische effecten van bètablokker-staken na MI. De bloeddruk en hartfrequentie stegen bescheiden, zonder klinische consequenties. Bètablokkerstaken na ongecompliceerd MI is hemodynamisch veilig.","abstract_original":"BACKGROUND AND AIMS: This study aims to report the effects of β-blocker interruption on blood pressure (BP) and heart rate (HR) in the AβYSS trial where patients were randomized to interruption or continuation of β-blocker treatment after a myocardial infarction (MI). METHODS: Changes in HR and BP from baseline to post-randomization are reported using linear mixed repeated model, in the 3698 patients of the AβYSS trial with a median follow-up of 3.0 years. Additionally, changes in HR and BP and the impact on the primary endpoint (death, MI, stroke, hospitalization for cardiovascular reason) in the pre-specified subgroups of patients with or without history of hypertension were assessed using linear mixed repeated and adjusted Cox proportional hazards model, respectively. RESULTS: β-blocker interruption was associated with significant increase {least square mean difference [95% confidence interval (CI)]} in systolic BP [+3.7 (2.6, 4.8) mmHg, P < .001], diastolic BP [+3.3 (2.6, 4.0) mmHg, P < .001], and resting HR [+10 [9, 11) b.p.m., P < .001] at 6 months that persisted over the duration of follow-up despite an increase in antihypertensive drugs in the β-blocker interruption group. The effects were observed in both hypertensive (43% of the population) and non-hypertensive patients. Hypertensive patients were at higher risk of events (25.8% vs. 19.2%) as compared with patients without hypertension (adjusted hazard ratio 1.18, 95% CI 1.01-1.36, P = .03). Patients with hypertension had a particularly marked increase in the primary endpoint (risk difference 5.02%, 0.72%-9.32%, P = .014) when randomized to β-blocker interruption. CONCLUSIONS: Interruption of β-blocker treatment after an uncomplicated MI led to a sustained increase in BP and HR, with potentially deleterious effects on outcomes, especially in patients with history of hypertension."}