beta-Blocker Use for Patients With or at Risk for Coronary Artery Disease In Reply

摘要

Dr Shang contends that our results are mostly confirmation of a well-known fact that atenolol is ineffective and may not be generalized to other beta-blockers such as carvedilol. This statement highlights the discordance between trials and practice and an optimism bias based on perceived benefit of a newer agent assessed by surrogate end points only. The well-known fact that atenolol is ineffective has not translated into clinical practice-atenolol was the second top generic drug based on retail dollars in 2010. The data on beta-blocker use in patients without heart failure are based on older agents and as a result, there is no guideline recommendation of a preferred beta-blocker.