Trial reportDrug safety2007
Discontinuation of beta-blockers and the risk of myocardial infarction in the elderly.
Trial report in Drug safety, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Deprescribing antihypertensive medications in older people: a systematic review and a meta-analysis.BMC geriatrics · 2026Pooled it
- Cardiac abnormalities after aneurysmal subarachnoid hemorrhage: effects of β-blockers and angiotensin-converting enzyme inhibitors.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2014Article
- Estimation of Drug Effectiveness by Modeling Three Time-dependent Covariates: An Application to Data on Cardioprotective Medications in the Chronic Dialysis Population.Statistics in biopharmaceutical research · 2014Article
- Article
- β-blocker continuation after noncardiac surgery: a report from the surgical care and outcomes assessment program.Archives of surgery (Chicago, Ill. : 1960) · 2012Article
- Discontinuing medications: a novel approach for revising the prescribing stage of the medication-use process.Journal of the American Geriatrics Society · 2008Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt has been shown that the abrupt cessation of treatment with beta-adrenoceptor antagonists (beta-blockers) increases the risk of myocardial infarction in patients with hypertension. As beta-blockers differ in their pharmacokinetic and pharmacodynamic properties, this risk of discontinuation might also differ between subgroups of beta-blockers.
objectiveTo determine whether discontinuation of beta-blockers is associated with an increased risk of myocardial infarction in elderly patients and whether the effects of recent cessation differs between subgroups of beta-blockers, categorised according to their selectivity, lipophilic profile and intrinsic sympathomimetic activity (ISA).
designA cohort study in users of beta-blockers within the Rotterdam Study, which was a prospective population-based follow-up study of 7983 individuals aged >or=55 years. PATIENTS: We identified 2588 individuals who had been treated with a beta-blocker for at least 30 days at any time during the study period of 1 January 1991 to 1 January 2002. In this group, 148 subjects developed incident myocardial infarction.
methodsDetailed information on the medication use and clinical characteristics of all patients were collected from the files of pharmacies, general practices and hospitals. Myocardial infarction was diagnosed on the basis of internationally accepted criteria and verified by a cardiologist. The duration of beta-blocker use was calculated from computerised pharmacy records on the basis of the number of dispensed tablets or capsules and the prescribed daily number. For every individual, on the index date (date of myocardial infarction in cases, the same date in controls [defined as any patient who had not experienced a myocardial infarction up to that timepoint]) the usage of beta-blockers was determined and classified as either current or as past use. Past use was classified into three different periods: cessation of beta-blockers less than 30 days; between 30 and 180 days; and more than 180 days before the index date. The risk of myocardial infarction in the three periods of cessation of exposure were analysed using a Cox proportional hazards model that included potential confounders and cardiac co-medication. These analyses were performed for the whole group and for subgroups of beta-blockers.
resultsDiscontinuation of any beta-blocker was not associated with an increased risk of myocardial infarction compared with current use of a beta-blocker. Analyses within subgroups showed that discontinuation of selective beta-blockers was associated with an increased risk of myocardial infarction compared with current use of any beta-blocker within the first 30 days (relative risk [RR] 2.70; 95% CI 1.06, 6.89) and also between 30 and 180 days after discontinuation (RR 2.44; 95% CI 1.07, 5.59). No increased risk was demonstrated in the other beta-blocker subgroups.
conclusionOverall, discontinuation of beta-blockers was not associated with an increased risk of myocardial infarction. However, when analysed by beta-blocker subgroup, cessation of selective beta-blockers was associated with an increased risk of myocardial infarction during the first 180 days after discontinuation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.