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January 13, 1999

β-Blockers as First-Line Agents for Hypertension in the Elderly—Reply

Author Affiliations

Margaret A.WinklerMDIndividualAuthorPhil B.FontanarosaMD, Senior EditorsIndividualAuthor

JAMA. 1999;281(2):131-133. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-2-jac80019

In Reply: In their previous review article Dr Kendall and colleagues1 stated, "Of all the therapies currently available for the prevention of sudden cardiac death none is more established or more effective than the beta-blockers."1 Exactly 1 month later, in the same journal, a case-control study on antihypertensive therapy and the risk of sudden death concluded, "that the use . . . of beta-blockers is associated with an increased risk of sudden death compared with other antihypertensive medications."2 These contradictory reports provide a good example of how confusing and poorly established the effects of β-blockers are with regard to primary prevention of cardiovascular disease.