β-Blocker Heart Attack Trial
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The β- Blocker Heart Attack Trial (BHAT) was a National Heart, Lung, and Blood Institute-sponsored multicentre, double- blind controlled clinical trial designed to test whether the regular administration of propranolol to men and women who had experienced at least 1 documented myocardial infarction would result in a significant reduction in all-cause mortality during the follow-up period. A total of 3837 persons aged 30 to 69 years were randomised to either propranolol or placebo, 5 to 21 days after infarction. Based on serum drug level, the prescribed maintenance dose of propranolol was either 180 or 240 mg/day. BHAT was stopped 9 months ahead of schedule due to a beneficial drug effect. Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. This difference was explained by a reduction in coronary heart disease mortality, both in sudden (defined as death within 1 hour of onset of symptoms) and non-sudden death. Serious side effects were uncommon. Based on the BHAT results, the use of propranolol is recommended for at least 3 years in patients with a recent myocardial infarction, who have no contraindications to β- blockade.
KeywordsCoronary Heart Disease Mortality Practolol Alprenolol Serum Drug Level Multicentre International Study
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