ß-Blockade for cardioprotection
- b-Blockers reduce mortality and reinfarction in patients after acute MI.1
- b-Blockers reduce the incidence of ventricular and atrial arrhythmias, including populations with a propensity for sudden cardiac death.1
- b-b-Blockers improve systolic function and reduce mortality and morbidity in patients with HF due to LV dysfunction.2
- b-Blockers have a wide therapeutic range in cardiovascular disease. Conditions where the level of evidence is lower include:
- - Diuretics and b-blockers are initial choices in the treatment of hypertension (unless contraindicated or there are special indications for other agents).3 Clinical trials have shown that these agents reduce morbidity and mortality and may prevent stroke, coronary artery disease, sudden death, and HF.
- - b-Blockers are recommended for secondary prevention in the management of patients with chronic stable angina without prior MI, where their combination of properties makes b-blockers extremely useful.4
1Kaplan NM. Beta blockade in the primary prevention of hypertensive cardiovascular events with focus on sudden cardiac death. Am J Cardiol. 1997;80(9B):20J-22J.
2Gomberg-Maitland M, Baram DA. Fuster V. Treatment for congestive heart failure: Guidelines for the primary care physician and the heart failure specialist. Arch Intern Med. 2001;161:342-352.
3The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med. 1997;157:2413-2446.
4Gersh BJ, Braunwald E, Bonow RO. Chronic coronary artery disease. In: Braunwald E, Zipes DP, Libby P, eds. Heart Disease. A Textbook of Cardiovascular Medicine. Vol 2. 6th ed. Philadelphia, Penn: W.B. Saunders; 2001:1272-1363.