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May 14, 1997

Adverse Outcomes of Underuse of β-Blockers in Elderly Patients-Reply

Author Affiliations

Community Hospital of Monterey Peninsula Monterey, Calif

JAMA. 1997;277(18):1437. doi:10.1001/jama.1997.03540420033023

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In Reply.  —We thank Dr Rumboldt and colleagues for relating the data from Spain and Croatia that show an initial low rate of use of β-blockers in post-AMI patients similar to that found in studies from the United States. Of particular interest is the evidence from Europe that the recommendation for use of β-blockers has increased markedly in the late 1980s and the 1990s. We must point out that in both locations the evidence for use of β-blockers is based on the fact that patients were advised to use them in discharge letters; a critical question, of course, is how many patients took the advice and how many continued to follow it.We applaud Dr Hein's support for traveling review team of diverse experts who travel to hospitals in Iowa to provide hands-on CME to local practitioners about issues in perinatal care. The program fulfills the criteria of modern and effective CME