Beta Blocker Discontinuation Before Treadmill Stress Testing

Rationale for Discontinuation

• Beta blockers attenuate exercise responses by limiting heart rate, which can significantly impact test interpretation and diagnostic accuracy, according to the American Heart Association 2, 3
• The chronotropic response (heart rate increase during exercise) is an important prognostic marker that is impaired by beta blocker use, as stated by the American College of Cardiology 1

Recommended Timing for Discontinuation

• Standard practice is to discontinue beta blockers within 24 to 48 hours of testing, as recommended by the American Heart Association 1

Cautions and Special Considerations

• Patients with recent acute coronary syndrome may experience rebound phenomena with abrupt discontinuation of beta blockers, according to the American College of Cardiology 2
• Patients with unstable angina or decompensated heart failure should not undergo exercise testing until their condition stabilizes, as advised by the American Heart Association 2

Post-Test Considerations

• Beta blockers should be reinstituted as soon as possible after the test in patients with coronary artery disease, as recommended by the American College of Cardiology 4