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Chapter-19 Which Beta-blockers are Recommended

BOOK TITLE: Practical Cardiology

Author
1. Khan M Gabriel
ISBN
9789386056016
DOI
10.5005/jp/books/18060_20
Edition
1/e
Publishing Year
2018
Pages
9
Author Affiliations
1. University of Ottawa; The Ottawa Hospital, Ottawa, Ontario, Canada
Chapter keywords
Beta-blocker, randomized clinical trial, RCT, myocardial infarction, MI, carvedilol, metoprolol, propranolol, sudden cardiac death, timolol

Abstract

The major beta-blocker discovery by Sir James Black, brought forth the novel beta-blocking agent propranolol used successfully for hypertension (Pritchard and Gillam 1964). Since, then more than 12 beta-blocking agents have been used worldwide in more than a billion patients. Soundly run large randomized clinical trials (RCTs) showed that propranolol and timolol significantly reduce total mortality and sudden deaths in patients followed for 2 years following myocardial infarction (MI). For the past decade beta-blockers have been demoted for the use in hypertensive patients and use for post-MI has decreased. This chapter covers the carvedilol, metoprolol, propranolol, sudden cardiac deaths, and timolol. Only timolol, propranolol, lipophilic agents, and β1 β2 blockers have been shown to significantly reduce, sudden cardiac death, total mortality and morbidity in post-MI patients followed for 2 years.

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