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DO BETA BLOCKERS FOR HYPERTENSION PREVENT CORONARY DISEASE?

Beta-adrenergic blockers have already been shown to be effective for secondary prevention of the complications of coronary heart disease in survivors of acute myocardial infarction. These data from an HMO population in Seattle indicate that these drugs may also be effective for primary prevention of coronary heart disease in patients with hypertension. In this case-control study, the 248 cases were patients with hypertension in whom angina or acute MI had been diagnosed between 1982 and 1984. The controls were 737 other hypertensive patients without known coronary heart disease who were drawn from the same HMO population during the same time period.

Use of beta blockers was less common in the cases than in the controls (adjusted relative risk, 0.62), with the most marked difference occurring in patients with nonfatal MI. These findings suggest that beta-adrenergic blocking agents offer advantages beyond blood pressure control for hypertensive patients, and support the use of beta blockers instead of diuretics as initial monotherapy for hypertension.

— THL

Published in Journal Watch General Medicine April 21, 1989

Citation(s):

Psaty BM et al. Beta-blockers and primary prevention of coronary heart disease in patients with high blood pressure. JAMA 1989 Apr 14 261 2087-2094.

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