The Relative Risk of Incident Coronary Heart Disease Associated With Recently Stopping the Use of β-Blockers

Bruce M. Psaty, Thomas D. Koepsell, Edward H. Wagner, James P. Logerfo, Thomas Inui

Research output: Contribution to journalArticle

236 Citations (Scopus)

Abstract

We conducted a population-based, case-control study of risk factors for first events of coronary heart disease in patients with high blood pressure. All subjects had hypertension treated with medication. The 248 cases presented with new coronary heart disease from 1982 through 1984, and the 737 controls were a probability sample of health maintenance organization patients free of coronary heart disease. The health maintenance organization’s computerized pharmacy database identified recent stoppers—patients who did not fill their prescriptions regularly enough to be at least 80% compliant. After adjustment for potential confounding factors, subjects who had recently stopped using β-blockers had a transient fourfold increase in the relative risk of coronary heart disease (relative risk, 4.5; 95% confidence interval, 1.1 to 18.5). The association was specific to β-blockers but not diuretics. A withdrawal syndrome immediately following the cessation of β-blocker use may be an acute precipitant of angina and myocardial infarction in hypertensive patients who have no prior history of coronary heart disease.

Original languageEnglish (US)
Pages (from-to)1653-1657
Number of pages5
JournalJournal of the American Medical Association
Volume263
Issue number12
DOIs
StatePublished - Mar 23 1990
Externally publishedYes

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Coronary Disease
Health Maintenance Organizations
Hypertension
Sampling Studies
Diuretics
Prescriptions
Case-Control Studies
Myocardial Infarction
Databases
Confidence Intervals
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The Relative Risk of Incident Coronary Heart Disease Associated With Recently Stopping the Use of β-Blockers. / Psaty, Bruce M.; Koepsell, Thomas D.; Wagner, Edward H.; Logerfo, James P.; Inui, Thomas.

In: Journal of the American Medical Association, Vol. 263, No. 12, 23.03.1990, p. 1653-1657.

Research output: Contribution to journalArticle

Psaty, Bruce M. ; Koepsell, Thomas D. ; Wagner, Edward H. ; Logerfo, James P. ; Inui, Thomas. / The Relative Risk of Incident Coronary Heart Disease Associated With Recently Stopping the Use of β-Blockers. In: Journal of the American Medical Association. 1990 ; Vol. 263, No. 12. pp. 1653-1657.
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