Underutilization of beta-blockers in older patients with prior myocardial infarction or coronary artery disease in an academic, hospital-based geriatrics practice.
OBJECTIVE
To investigate the prevalence of beta-blocker use in older persons with prior myocardial infarction (MI) or coronary artery disease (CAD) without contraindications to beta-blockers in an academic hospital-based geriatrics practice.


METHODS
A retrospective analysis of charts from all older patients seen during January 1996 through March 1997 at an academic, hospital-based geriatrics practice was performed to investigate the prevalence of beta-blocker use in older patients with prior MI or CAD without contraindications to beta blockers.


METHODS
An academic, hospital-based, primary care geriatrics practice staffed by fellows in a geriatrics training program and full-time faculty geriatricians.


METHODS
One hundred thirty-nine women and 84 men, mean age 82 +/- 8 years (range 67 to 96), were included in the study.


RESULTS
Of 233 patients with CAD, 53 patients (23%) were receiving beta-blockers. Of 180 patients with CAD not receiving beta-blockers, 34 patients (19%) had contraindications to beta-blockers. Of 199 patients with CAD without contraindications to beta-blockers, 53 patients (27%) were receiving beta blockers. Of 162 patients with prior MI, 38 patients (23%) were receiving beta-blockers. Of 124 patients with prior MI not receiving beta-blockers, 19 patients (15%) had contraindications to beta-blockers. Of 143 patients with prior MI without contraindications to beta-blockers, 38 patients (27%) were receiving beta-blockers.


CONCLUSIONS
There is marked underutilization of beta-blockers in treating older patients with prior MI or CAD in an academic, hospital-based geriatrics practice.
Mendelson
G
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Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, New York, USA.
Aronow
W S
WS
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000075202:Contraindications; D003327:Coronary Disease / Q000188:drug therapy*; D004363:Drug Utilization; D005260:Female; D005853:Geriatrics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy*; D009518:New York; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies
D000319:Adrenergic beta-Antagonists