Does early treatment with anti-hypertensive drugs reduce short and long-term mortality in patients with an acute myocardial infarction?
Early administration of nitrates and ACE inhibitors post-myocardial infarction provides early mortality benefits, whereas immediate beta-blockers and calcium channel blockers do not.
Nitrates reduce mortality (4-8 deaths prevented per 1000) at 2 days when administered within 24 hours of symptom onset of an acute myocardial infarction. No mortality benefit was seen when treatment continued beyond 48 hours. Mortality benefit of immediate treatment with ACE inhibitors post MI at 2 days did not reach statistical significance but the effect was significant at 10 days (2-4 deaths prevented per 1000). There is good evidence for lack of a mortality benefit with immediate or short-term treatment with beta-blockers and calcium channel blockers for acute myocardial infarction.
Perez et al. (Wed,) studied this question.