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Drugs & Aging

, Volume 11, Issue 6, pp 424–432 | Cite as

Postinfarction Use of β-Blockers in Elderly Patients

  • Wilbert S. Aronow
Leading Article

Summary

β-Adrenoceptor antagonists (β-blockers) reduce mortality and recurrent myocardial infarction (MI) in older patients after both Q-wave MI and non—Q-wave ML The effects of β-blockers are to: (i) reduce complex ventricular arrhythmias, including ventricular tachycardia; (ii) increase the ventricular fibrillation threshold; (iii) reduce myocardial ischaemia; (iv) decrease sympathetic tone; (v) markedly attenuate the circadian variation of complex ventricular arrhythmias; (vi) abolish the circadian variation of myocardial ischaemia; and (vii) abolish the circadian variation of sudden cardiac death or MI.

β-Blockers reduce mortality in patients with MI and complex ventricular arrhythmias. In addition, they are excellent antianginal agents. Older persons with hypertension who have had an MI should be treated initially with a β-blocker.

β-Blockers reduce mortality in patients with: (i) diabetes mellitus who have had an MI; (ii) MI and congestive heart failure with an abnormal or normal left ventricular ejection fraction; and (iii) MI and an asymptomatic abnormal left ventricular ejection fraction. Severe congestive heart failure, severe peripheral arterial disease with threatening gangrene, greater than first degree atrioventricular block, hypotension, bradycardia, lung disease with bronchospasm, and bronchial asthma are contraindications to treatment with β-blockers.

Keywords

Propranolol Left Ventricular Ejection Fraction Sudden Cardiac Death Timolol Circadian Variation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Adis International Limited 1997

Authors and Affiliations

  • Wilbert S. Aronow
    • 1
    • 2
  1. 1.Department of Geriatrics and Adult DevelopmentMount Sinai School of MedicineNew YorkUSA
  2. 2.Hebrew Hospital HomeBronxUSA

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