Optimizing beta-blocker use after myocardial infarction.
Although beta-adrenergic blockers can significantly reduce mortality after a myocardial infarction, these agents are prescribed to only a minority of patients. Underutilization of beta blockers may be attributed, in part, to fear of adverse effects, especially in the elderly and in patients with concomitant disorders such as diabetes or heart failure. However, studies have shown that such patients are precisely the ones who derive the greatest benefit from beta blockade. Advancing age or the presence of potentially complicating disease states is usually not a justification for withholding beta-blocker therapy. With use of cardioselective agents and through careful dosing and monitoring, the benefits of beta blockers after myocardial infarction far outweigh the potential risks in most patients.
Howard
P A
PA
Department of Pharmacy, University of Kansas Medical Center, Kansas City 66160-7231, USA.
Ellerbeck
E F
EF
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D000075202:Contraindications; D048909:Diabetes Complications; D004363:Drug Utilization / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D008171:Lung Diseases / Q000150:complications; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control*; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013664:Teaching Materials; D014481:United States
D000319:Adrenergic beta-Antagonists