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Beta-Blockers Underused In Older Patients After Heart Attacks, Major Study Of 45,000 Patients 65 Years Or Older Reveals

New Haven, Conn. -- Beta-blockers are not prescribed for many older patients who could benefit from their use after heart attacks, according to an article in the Aug. 19 issue of The Journal of the American Medical Association (JAMA). In fact, the study found that only half of 45,000 patients who were ideal candidates for the possibly life-prolonging treatment were prescribed beta-blockers when they were released from the hospital.

"Given that mortality after acute myocardial infarction is high in the elderly and that beta-blockers reduce mortality in this group, our findings reveal an ample opportunity to improve the care and outcomes for such patients," said Harlan M. Krumholz, M.D., from the Yale School of Medicine and the Yale-New Haven Hospital Center for Outcomes Research and Evaluation.

Krumholz and his colleagues examined a database of Medicare beneficiaries that were 65 years old or older who had been discharged from the hospital after an acute myocardial infarction (sudden heart attack), a condition in which part of the heart muscle suddenly dies.

Anyone who has had such a heart attack is at increased risk to experience another in the first few years following his or her initial heart attack. Beta-blockers often reduce the risk of further damage to the heart muscle and thereby the risk of another, and potentially fatal, heart attack, Krumholz said.

The importance of beta-blockers as preventive therapy after acute myocardial infarction has been established in younger patients. This study found a similar benefit for Medicare beneficiaries 65 years old or older. Patients in the study receiving beta-blocker therapy at the time of discharge had a 14 percent lower risk of death at one year after discharge.

The study also showed the influence of the hospital as an appropriate setting for beginning this important preventative therapy, Krumholz said.

Of the patients who were not
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Contact: Cynthia Atwood
cynthia.atwood@yale.edu
203-432-1345
Yale University
18-Aug-1998


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