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May 14, 1997

Adverse Outcomes of Underuse of β-Blockers in Elderly Patients

Author Affiliations

Split, Croatia

JAMA. 1997;277(18):1435-1436. doi:10.1001/jama.1997.03540420031019

To the Editor.  —The timely and most instructive article by Soumerai et al1 about the underuse of β-blockers in secondary prevention of MI in the New Jersey area (only 21% of the eligibile elderly patients were receiving such a therapy) prompted us to report a related comparison from Europe. Analyzing the discharge letters issued to patients successfully treated for AMI in Barcelona, Spain, Agusti et al2 have shown that in 1983 only 20% of the patients were advised to take β-blockers; this figure increased to 34% in 1988. At the time of discharge, all patients discharged from Barcelona hospitals receive enough medicine to last them for a few days and a discharge letter recommending that their family physicians should prescribe the same treatment for them. Assessing discharge letters sent to all patients with a diagnosis of AMI in Split, Croatia (another Mediterranean town with similar climate and approach), we3 found