Clinical utility of beta-blockers for primary and secondary prevention of coronary artery disease

With advances in pharmacotherapeutic and nonpharmacotherapeutic interventions, the overall treatment of coronary artery disease (CAD) looks very different today compared with historical standards of care from previous decades. As a result, it is necessary to periodically re-evaluate pharmacotherapy for utility and safety. Throughout history, beta-blockers have played a role in primary and secondary prevention, as well as treatment of CAD. In evaluating the available evidence supporting the widespread use of beta-blockers for multiple indications, many of the studies are dated and were conducted in an era prior to implementation of important current pharmacotherapy (i.e., statins). This article reviews recently published data from a longitudinal observational analysis of beta-blocker use and outcomes in patients with CAD (with and without prior myocardial infarction [MI]), as well as in patients with CAD risk factors only.