post mi beta blocker doses

Posted by Michelle Boyer on April 16, 1999 at 16:12:25
I am a pharmacist working with a managed care organization.  I am on a cardiac care task force to improve post MI beta blocker compliance.  Other medical professionals in the group stated that there are some recent studies indicating that doses of beta blockers for post MI patients should be lower than what is currently recommended.  Have you heard anything about this?  Has the AHA adopted any guidelines promoting lower doses for beta blockers post mi?  Can you tell me where any of these studies have been published?  Thank you in advance for your response.

Posted by CCF CARDIO MD-APS on April 22, 1999 at 22:14:48
Dear Michelle,
I know of NO such studies or theories, however it is well known that a patient with any heart failure symptoms should be very CAREFULLY started on beta blockers (as opposed to the post MI patient without heart failure.)
Such theories may exist, however they remain that "theoretical" and hence unproven in large clinical trials which is how we guide the practice of medicine as well as the institution of AHA and ACC guidelines.
At your local medical library, or on the WWWeb, you can search medline or any medical literature search program to look specifically for such theories in respectable journals like JACC, NEJM, Lancet, AJC, and CIRCULATION.
I hope this information is useful. Information provided in the heart forum is for
general purposes only.  Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!