This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.
Please go to www.ahrq.gov for current information.
Beta Blockers Shown To Be Underused, Reducing Survival After Heart Attack
Media Advisory Date: January 7, 1997
Elderly patients who receive beta blockers following a heart
attack are 43 percent less likely to die
in the first 2 years following the attack than patients who do
not receive this drug, according to a
new study funded by the Agency for Health Care Policy and
Research (AHCPR), published in the
January 8 issue of The Journal of the American Medical
The study found that patients who receive beta blockers are
rehospitalized for heart ailments 22
percent less often than those who do not get beta blockers.
However, only 21 percent of eligible
patients receive beta blocker therapy.
The researchers examined hospital discharge, drug use and
mortality data for 5,332 Medicare
beneficiaries in New Jersey who were 30-day survivors of an acute
myocardial infarction (AMI).
These patients all had prescription drug coverage; of these,
3,737 were eligible for beta blocker
Researchers found that these patients were almost three times as
likely to receive a new
prescription for a calcium channel blocker than for a beta
blocker after their AMI. Eligible
patients receiving calcium channel blockers instead of beta
blockers doubled their risk of
Advanced age (over age 75), heart failure, and use of calcium
channel blockers were likely to
mean that the patient would not receive beta blocker therapy. The
researchers concluded that
underuse of beta blockers in this population leads to an
increased rate of hospitalization and
mortality. The study is the first to demonstrate the survival
benefits of long-term beta blocker
treatment in patients over age 75, a group that has been excluded
from the clinical trials.
The National Committee for Quality Assurance (NCQA) used the
findings of this study as the
basis for changing the performance measurement for beta blocker
use after AMI to include
patients over 75 years of age in the most recent version of the
Health Plan Employer Data and
Information Set (HEDIS 3.0). NCQA is expanding HEDIS, its managed
care survey tool, to
include the Medicare population. HEDIS is being used by the
Health Care Financing
Administration (HCFA) to assess the quality provided by Medicare
HMOs. HCFA asked NCQA
to include the measure after preliminary results of the study
were presented last spring.
The study, entitled "Adverse Outcomes of Underuse of Beta
Blockers in Elderly Survivors of
Acute Myocardial Infarction," conducted by Stephen B. Soumerai,
Sc.D. of Harvard Medical
School and Harvard Pilgrim Health Care and colleagues, is a
component of AHCPR's
Pharmaceutical Outcomes Research Program.
To arrange an interview with Dr. Stephen Soumerai, please contact
Patti Embry-Tautenhan at
Harvard Pilgrim Health Care, (617) 731-7413.
For additional information, contact AHCPR Public Affairs: Karen Carp,
(301) 427-1858; Karen Migdail, (301) 427-1855 ; Salina Prasad, (301) 427-1864.