What is a primary goal of beta-blocker therapy in ACS?

• A. Reduce myocardial oxygen demand
• B. Increase heart rate
• C. Increase contractility
• D. Increase blood pressure

Answer: (A)

In ACS, the goal of beta-blocker therapy is to reduce the heart’s oxygen needs by lowering its workload. By blocking sympathetic stimulation, these meds slow the heart rate and decrease the force of contraction, which lowers myocardial oxygen consumption. They also tend to reduce systolic blood pressure, cutting afterload. Slower heart rates lengthen diastole, giving more time for coronary perfusion and helping ischemic areas receive blood while demand is reduced. This combination helps limit infarct size and prevent arrhythmias, improving outcomes.

Increasing heart rate would raise oxygen demand and worsen ischemia; increasing contractility would do the same; increasing blood pressure would raise afterload and oxygen demand, which is not desirable in ACS.