PREVALENCE OF USE OF BETA-BLOCKERS AND OF CALCIUM-CHANNEL BLOCKERS INOLDER PATIENTS WITH PRIOR MYOCARDIAL-INFARCTION AT THE TIME OF ADMISSION TO A NURSING-HOME
Ws. Aronow, PREVALENCE OF USE OF BETA-BLOCKERS AND OF CALCIUM-CHANNEL BLOCKERS INOLDER PATIENTS WITH PRIOR MYOCARDIAL-INFARCTION AT THE TIME OF ADMISSION TO A NURSING-HOME, Journal of the American Geriatrics Society, 44(9), 1996, pp. 1075-1077
OBJECTIVE: To investigate the prevalence of beta blocker use and calci
um channel blocker use in older patients with prior myocardial infarct
ion at the time of admission to a nursing home. DESIGN: In a prospecti
ve study of 500 consecutive patients aged 60 years or older admitted t
o a nursing home, 202 (40%) had electrocardiographic evidence of Q-wav
e myocardial infarction at the time of admission. The prevalence of be
ta blocker use and of calcium channel blocker use was investigated in
these 202 patients with previous myocardial infarction. The prevalence
of beta blocker use and of calcium channel blocker use was also inves
tigated in patients with myocardial infarction and abnormal left ventr
icular (LV) ejection fraction. SETTING: A large long-term health care
facility. PATIENTS: The patients included 344 women and 156 men, mean
age 81 +/- 8 years (range 60 to 100). MEASUREMENTS AND MAIN RESULTS: O
f 500 patients, 202 (40%) had Q-wave myocardial infarction at the time
of admission to the nursing home. Seventeen (8%) of these 202 patient
s with myocardial infarction were receiving beta blockers and 74 (37%)
were receiving calcium channel blockers at the time of admission. Of
171 patients with myocardial infarction who had technically adequate m
easurements of LV ejection fraction, 59 (35%) had an abnormal LV eject
ion fraction (<50%). Of the 59 patients with previous myocardial infar
ction and abnormal LV ejection fraction, four (7%) were receiving beta
blockers and 19 (32%) were receiving calcium channel blockers at the
time of admission. CONCLUSIONS: Beta blockers are underutilized, and c
alcium channel blockers are overutilized in the treatment of older pat
ients with a history of myocardial infarction at the time of admission
to a nursing home.