Key result
Aspirin, beta-blockers, and verapamil are proven to mitigate mortality and morbidity post-myocardial infarction, whereas convincing mortality data for newer antihypertensive agents is lacking.
Why the study?
Despite evidence supporting aspirin, beta blockers, and certain calcium channel blockers for post-MI secondary prevention, mortality data for newer antihypertensive agents remain lacking.
What are the proven drug treatments for secondary prevention of mortality and morbidity in survivors of acute myocardial infarction?
What are the proven drug treatments for secondary prevention of mortality and morbidity in survivors of acute myocardial infarction?
This review highlights the established role of aspirin, beta-blockers, and specific calcium channel blockers in post-MI secondary prevention, emphasizing the need for mortality data for newer antihypertensive agents.
Reinforces aspirin, beta-blockers, and verapamil for post-MI secondary prevention; leaves open mortality benefits of newer antihypertensives pending further trials.
About 10% of survivors of an acute myocardial infarction will die in the following year. Thereafter the risk declines but reinfarction is still an important cause of mortality and morbidity. The post infarction trials have clearly shown that the best proven agents to mitigate this toll are aspirin, beta adrenoceptor blockers, and verapamil (but not other calcium blockers, except diltiazem for non Q wave infarction). In the context of hypertension treatment these post infarction trials may have important lessons for drug selection and ancillary treatment since the majority of subjects will ultimately die of ischaemic heart disease. Although the newer agents such as ACE and renin inhibitors, newer calcium channel blockers and alpha blockers have many promising properties in terms of risk factor reduction, no convincing mortality data exists; it is needed. This review will deal with the known effects (both good and bad) of antihypertensive agents and will also review other drug strategies relevant to the hypertensive patient. It will also point out large areas of ignorance.
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Peter Sleight (1992) conducted a review in Myocardial infarction and hypertension. Antihypertensive agents and other drug strategies was evaluated. Aspirin, beta-blockers, and verapamil are proven to mitigate mortality and morbidity post-myocardial infarction, whereas convincing mortality data for newer antihypertensive agents is lacking.
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