Ischaemic heart disease: how well are the risk profiles modulated by current beta blockers?

Cardiology
P Leren

Abstract

In acute myocardial infarction, intravenous beta blocker therapy has been tested in about 30 controlled, randomized trials. Of these, the ISIS-1 using atenolol and the MIAMI trial using metoprolol are the most important. In a total of 26,437 patients, total deaths were reduced by 62 during day 1 and by 64 during the first week, i.e. 97% of the lives were saved during the first day of beta blocker treatment. In post-myocardial infarction, oral beta blocker maintenance treatment has been used in about 35,000 survivors in placebo-controlled trials. Of these, the timolol, metoprolol and propranolol (BHAT) trials are the most important. In the timolol trial lasting for 33 months, total death, total cardiac death and re-infarction rate were significantly reduced. In the metoprolol study lasting for 3 months, total and cardiac mortality were reduced, and in the BHAT study lasting for 25 months fatal and non-fatal re-infarction combined was significantly reduced. Primary prevention of coronary heart disease has been the intention in hypertension trials. Despite the fact that beta blockers are potent agents against elevated blood pressure, a well-established coronary risk factor, no controlled trial with a placebo or untreated control g...Continue Reading

Citations

Dec 23, 1998·Survey of Ophthalmology·W C Stewart, J Osterman
Aug 1, 1995·Circulation·E FalkV Fuster

Related Concepts

Adrenergic beta-Antagonists
Antihypertensive Agents
Coronary Heart Disease
Hypertensive Disease
Myocardial Infarction
Controlled Clinical Trials, Randomized

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