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QUESTION: In patients who have had myocardial infarction, heart failure, or hypertension, do β blockers increase depressive symptoms, fatigue, and sexual dysfunction?
Studies were identified by searching Medline (1966–2001) with the keywords myocardial infarction, heart failure, or hypertension in combination with the keywords adrenergic β antagonists and trial; and by scanning reference lists.
English language studies were selected if they were randomised controlled trials with a placebo comparison, were not crossover trials, enrolled ≥100 patients, and had ≥6 months of follow up.
Data were extracted on number of patients; presence of heart failure, hypertension, or myocardial infarction; length of follow up; type of β blocker; and patient reported adverse events (ie, depressive symptoms, fatigue, …
Source of funding: not stated.
For correspondence: Dr H M Krumholz, Yale University School of Medicine, New Haven, CT, USA.
Abstract and commentary also published in ACP Journal Club