Format

Send to

Choose Destination
Ann Intern Med. 1995 Sep 1;123(5):358-67.

Beta-blockers and sudden cardiac death.

Author information

1
Queen Elizabeth Hospital, Birmingham, United Kingdom.

Abstract

OBJECTIVES:

To 1) consider the problem of sudden death from heart disease and the role of beta-blockers and other agents in preventing sudden death and 2) review perceived problems with beta-blocker therapy, such as effects on blood lipids, complications in diabetes, and adverse effects on heart failure and quality of life.

DATA SOURCES:

MEDLINE and EMBASE searches done from July 1994 on, and recognized texts.

STUDY SELECTION:

More than 400 original and review articles were evaluated, of which the most relevant were selected.

DATA EXTRACTION:

Data were extracted and reviewed by two authors. Accuracy was confirmed, when necessary, by the other authors.

DATA SYNTHESIS:

Of all of the therapies currently available for the prevention of sudden cardiac death, none is more established or more effective than beta-blockers. Indeed, the evidence that beta-blockers have a cardioprotective effect is compelling. They probably reduce the rate of atheroma formation; they reduce the risk for ventricular fibrillation in animal models of myocardial ischemia; they appear to reduce cardiac mortality in primary prevention trials; and they reduce mortality, particularly from sudden death, in patients who have had infarction. Moreover, withholding beta-blockers because of problems perceived to be associated with them is usually not warranted and may frequently prevent their use in those who will benefit most from them.

CONCLUSION:

Clinicians should reappraise the evidence for the significant effect of beta-blockers on morbidity and mortality, and they should recognize the importance of initiating and maintaining beta-blocker therapy when the less well-informed might suggest otherwise.

Comment in

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center