Posted by steve giddings on May 17, 2002 at 07:01:56:
In Reply to: Re: Toprol XL posted by Dave Funderburg on May 15, 2002 at 18:53:29:
There is also compelling evidence that AcE inhibitors are effective in decreasing cardiac risk (for MI) and all cause mortality in prmary prevention trials, that is in individuals who have not had an MI but who are at risk. The effectiveness of beta blockers as a primary prevention intervention is argued. There is no well done single trial, even though these drugs have been around longer than most others. The reasons for lack of evidnce are likely more economic than scientific. Drug companies are the major sponsors for these trials, and almost all beta blockers are out of patent. There are very good reasons to think that beta blockers are antiatherogenic. They are cheap and they are effective for both rate control and for hypertension. In example, It took a very long time to get an aspirin trial done, even though their non-reversible on cyclooxenase blockade/ their antiplatelet activation effects were known for years. In contrast, clopidigrel(Plavix) trials were complete I think even before the drug was FDA approved.