β-Blockers and Progression of Coronary Atherosclerosis
Authors: Ilke Sipahi, Steven E. Nissen
Journal: Annals of Internal Medicine (2008)

Letters4 March 2008β-Blockers and Progression of Coronary AtherosclerosisIlke Sipahi, MD and Steven E. Nissen, MDIlke Sipahi, MDFrom the Cleveland Clinic, Cleveland, OH 44195.Search for more papers by this author and Steven E. Nissen, MDFrom the Cleveland Clinic, Cleveland, OH 44195.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-5-200803040-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Dunaway's statement that “[p]rospective studies have shown no decreased incidence of myocardial infarction (MI) and stroke in patients treated with β-blockers versus placebo” is not true. The meta-analyses by Lindholm and colleagues (1) and Bradley and colleagues (2), involving more than 20 000 patients with hypertension, showed that β-blockers statistically significantly reduced the incidence of stroke by 19% compared with placebo (95% CI for relative risk, 0.71 to 0.93). Although a non–statistically significant reduction in incidence of MI occurred in these meta-analyses (CI for relative risk, 0.83 to 1.05), β-blockers statistically significantly reduced the incidence of MI by ...References1. Lindholm LH, Carlberg B, Samuelsson O. Should beta blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet. 2005;366:1545-53. [PMID: 16257341] CrossrefMedlineGoogle Scholar2. Bradley HA, Wiysonge CS, Volmink JA, Mayosi BM, Opie LH. How strong is the evidence for use of beta-blockers as first-line therapy for hypertension? Systematic review and meta-analysis. J Hypertens. 2006;24:2131-41. [PMID: 17053529] CrossrefMedlineGoogle Scholar3. Timolol-induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction. N Engl J Med. 1981;304:801-7. [PMID: 7010157] CrossrefMedlineGoogle Scholar4. Julian DG, Prescott RJ, Jackson FS, Szekely P. Controlled trial of sotalol for one year after myocardial infarction. Lancet. 1982;1:1142-7. [PMID: 6122937] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the Cleveland Clinic, Cleveland, OH 44195.Disclosures: Dr. Sipahi has received an educational grant from Pfizer and lecture honoraria from AstraZeneca. Dr. Nissen has received research support from AstraZeneca, Eli Lilly, Pfizer, Takeda, Sankyo, and Sanofi-Aventis. Dr. Sipahi has also consulted for many pharmaceutical companies without financial compensation. All honoraria, consulting fees, or other payments from any for-profit entity are paid directly to charity so that no income or tax deduction is received. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee Alsoβ-Blockers and Progression of Coronary Atherosclerosis: Pooled Analysis of 4 Intravascular Ultrasonography Trials Ilke Sipahi , E. Murat Tuzcu , Katherine E. Wolski , Stephen J. Nicholls , Paul Schoenhagen , Bo Hu , Craig Balog , Mehdi Shishehbor , William A. Magyar , Timothy D. Crowe , Samir Kapadia , and Steven E. Nissen β-Blockers and Progression of Coronary Atherosclerosis L. Joe Dunaway Metrics 4 March 2008Volume 148, Issue 5Page: 404-405KeywordsAntihypertensivesConflicts of interestHypertensionMyocardial infarctionStable coronary artery diseaseStrokeTaxes ePublished: 4 March 2008 Issue Published: 4 March 2008 CopyrightCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...