A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results
- PMID: 7038157
- DOI: 10.1001/jama.1982.03320370021023
A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results
Abstract
The beta-Blocker Heart Attack Trial (BHAT) was a National Heart, Lung, and Blood Institute-sponsored, multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period. During a 27-month interval, 3,837 persons between the ages of 30 and 69 years were randomized to either propranolol (1,916 persons) or placebo (1,912 persons), five to 21 days after the infarction. Depending on serum drug levels, the prescribed maintenance dose of propranolol hydrochloride was either 180 or 240 mg/day. The trial was stopped nine months ahead of schedule. Total mortality during the average 24-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. Sudden cardiac death, a subset of ASHD mortality, was 3.3% among the propranolol patients and 4.6% among the placebo patients. Serious side effects were uncommon. Hypotension, gastrointestinal problems, tiredness, bronchospasm, and cold hands and feet occurred more frequently in the propranolol group. Based on the BHAT results, the use of propranolol in patients with no contraindications to beta-blockade who have had a recent myocardial infarction is recommended for at least three years.
Similar articles
-
Propranolol therapy in patients with acute myocardial infarction: the Beta-Blocker Heart Attack Trial.Circulation. 1983 Jun;67(6 Pt 2):I53-7. Circulation. 1983. PMID: 6342840 Clinical Trial.
-
Beta Blocker Heart Attack Trial: design features.Control Clin Trials. 1981 Dec;2(4):275-85. doi: 10.1016/0197-2456(81)90018-0. Control Clin Trials. 1981. PMID: 6120793 Clinical Trial.
-
A randomized trial of propranolol in patients with acute myocardial infarction. II. Morbidity results.JAMA. 1983 Nov 25;250(20):2814-9. doi: 10.1001/jama.1983.03340200048027. JAMA. 1983. PMID: 6358542 Clinical Trial.
-
Effects of beta blockade on sudden cardiac death during acute myocardial infarction and the postinfarction period.Am J Cardiol. 1997 Nov 13;80(9B):35J-39J. doi: 10.1016/s0002-9149(97)00837-0. Am J Cardiol. 1997. PMID: 9375948 Review.
-
Use of beta-adrenergic blocking agents after myocardial infarction.Postgrad Med. 1985 Dec;78(8):40-6, 49-53. doi: 10.1080/00325481.1985.11699218. Postgrad Med. 1985. PMID: 2866506 Review.
Cited by
-
Management of ventricular tachycardia in heart failure.Methodist Debakey Cardiovasc J. 2013 Jan-Mar;9(1):20-5. doi: 10.14797/mdcj-9-1-20. Methodist Debakey Cardiovasc J. 2013. PMID: 23519088 Free PMC article. Review.
-
Is heart rate a treatment target in heart failure?Curr Cardiol Rep. 2012 Jun;14(3):308-13. doi: 10.1007/s11886-012-0260-3. Curr Cardiol Rep. 2012. PMID: 22407354 Review.
-
Reducing the risks of sudden death and heart failure post myocardial infarction: utility of optimized pharmacotherapy.Clin Cardiol. 2005 Nov;28(11 Suppl 1):I19-27. doi: 10.1002/clc.4960281305. Clin Cardiol. 2005. PMID: 16450809 Free PMC article. Review.
-
Real-world algorithms for the optimal use of drugs and devices in the patient post myocardial infarction and the future of post myocardial infarction management.Clin Cardiol. 2005 Nov;28(11 Suppl 1):I58-63. doi: 10.1002/clc.4960281310. Clin Cardiol. 2005. PMID: 16450814 Free PMC article. Review.
-
Long-Term Follow-Up After Acute Myocardial Infarction According to Beta-Blocker Dose.Am J Med. 2023 May;136(5):458-465.e3. doi: 10.1016/j.amjmed.2023.02.006. Epub 2023 Feb 21. Am J Med. 2023. PMID: 36822258 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical