Beta-blockade in ischemic heart disease and hypertension

The effect of beta-blocking agents on post-myocardial infarction patients with a history of hypertension or elevated blood pressure (BP) at baseline in two prospective placebo-controlled postinfarction studies using beta-adrenoceptor blocking agents (the Stockholm Metoprolol Trial and the Norwegian Timolol Study) is discussed. The results of both of these trials indicate that active beta-blockade reduces the incidence of nonfatal reinfarction, although the BP levels were similar in the two treatment groups. The differences in the efficacy of treatment in previous studies of hypertension are discussed. So far, none of the studies has shown a significant difference in mortality when different antihypertensive therapies have been compared in the same study. Some aspects of designing future trials comparing different treatment regimens in hypertension are discussed.