β-Blocker therapy in acute myocardial infarction: Evidence for underutilization in the elderly

Jerry H. Gurwitz, Robert J. Goldberg, Zuoyao Chen, Joel M. Gore, Joseph S Alpert

Research output: Contribution to journalArticle

121 Citations (Scopus)

Abstract

purpose: To assess the impact of patient age on the use of β-blocker therapy in the management of acute myocardial infarction. patients and methods: The population studied consisted of 4,762 patients hospitalized with validated acute myocardial infarction in 16 hospitals in the Worcester, Massachusetts, Standard Metropolitan Statistical Area during the years 1975, 1978, 1981, 1984, 1986, and 1988. Logistic regression analysis was employed to control for relevant demographic and clinical variables in evaluating the independent effect of patient age as a determinant of receipt of β-blocker therapy during the hospitalization. results: A consistent trend toward reduced use of β-blocker therapy in older patients was demonstrated. After adjustment for demographic and clinical variables (gender; prior history of angina, hypertension, or diabetes mellitus; myocardial infarction characteristics; complications including congestive heart failure and shock; and use of digoxin and diuretics), odds ratios for receipt of β-blocker therapy relative to patients less than 55 years of age were 0.61 for those 55 to 64; 0.52 for those 65 to 74; 0.36 for those 75 to 84; and 0.26 for those 85 or older. Analyses performed for each study year demonstrated results consistent with those for the overall study population. conclusion: The results of this population-based study suggest that there are substantial opportunities for expanded use of β-blocker therapy in elderly patients who have sustained an acute myocardial infarction.

Original languageEnglish (US)
Pages (from-to)605-610
Number of pages6
JournalAmerican Journal of Medicine
Volume93
Issue number6
DOIs
StatePublished - 1992
Externally publishedYes

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Myocardial Infarction
Therapeutics
Demography
Population
Digoxin
Diuretics
Shock
Diabetes Mellitus
Hospitalization
Heart Failure
Logistic Models
Odds Ratio
Regression Analysis
Hypertension

ASJC Scopus subject areas

  • Nursing(all)

Cite this

β-Blocker therapy in acute myocardial infarction : Evidence for underutilization in the elderly. / Gurwitz, Jerry H.; Goldberg, Robert J.; Chen, Zuoyao; Gore, Joel M.; Alpert, Joseph S.

In: American Journal of Medicine, Vol. 93, No. 6, 1992, p. 605-610.

Research output: Contribution to journalArticle

Gurwitz, Jerry H. ; Goldberg, Robert J. ; Chen, Zuoyao ; Gore, Joel M. ; Alpert, Joseph S. / β-Blocker therapy in acute myocardial infarction : Evidence for underutilization in the elderly. In: American Journal of Medicine. 1992 ; Vol. 93, No. 6. pp. 605-610.
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