Underutilization of beta-blockers in older patients with prior myocardial infarction or coronary artery disease in an academic, hospital-based geriatrics practice

OBJECTIVE: To investigate the prevalence of beta-blocker use in older persons with prior myocardial infarction (MI) or coronary artery disease (CAD) without contraindications to beta-blockers in an academic hospital-based geriatrics practice. DESIGN: A retrospective analysis of charts from all older patients seen during January 1996 through March 1997 at an academic, hospital-based geriatrics practice was performed to investigate the prevalence of beta-blocker use in older patients with prior MI or CAD without contraindications to beta blockers. SETTING: An academic, hospital-based, primary care geriatrics practice staffed by fellows in a geriatrics training program and full-time faculty geriatricians. PATIENTS: One hundred thirty-nine women and 84 men, mean age 82 +/- 8 years (range 67 to 96), were included in the study. MEASUREMENTS AND MAIN RESULTS: Of 233 patients with CAD, 53 patients (23%) were receiving beta-blockers. Of 180 patients with CAD not receiving beta-blockers, 34 patients (19%) had contraindications to beta-blockers. Of 199 patients with CAD without contraindications to betablockers, 53 patients (27%) were receiving beta blockers. Of 162 patients with prior MI, 38 patients (23%) were receiving beta-blockers. Of 124 patients with, prior MI not receiving beta-blockers, 19 patients (15%) had contraindications to beta-blockers. Of 143 patients With prior MI without contraindications to beta-blockers, 38 patients (27%) were receiving beta-blockers. CONCLUSIONS: There is marked underutilization of beta-blockers in treating older patients with prior MI or CAD in an academic, hospital-based geriatrics practice.