Effect of beta blockers on incidence of new coronary events in older persons with prior myocardial infarction and symptomatic peripheral arterial disease

Beta blockers reduce the incidence of new coronary events in older patients after myocardial infarction.(1-4) Patients with peripheral arterial disease (PAD) are at increased risk for developing coronary events.(5-8) Many physicians have been reluctant to use p blockers in patients with PAD because of concerns that beta blockers will aggravate intermittent claudication. However, a meta-analysis of 11 randomized controlled studies found that beta blockers do not adversely affect walking capacity or the symptoms of intermittent claudication in patients with mild-to-moderate PAD.(9) We report data from an observational study investigating the effect of beta blockers on the incidence of new coronary events in older patients with symptomatic PAD and prior myocardial infarction.