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Review: β blockers increase fatigue and sexual dysfunction but not depression after myocardial infarction

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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?

Data sources

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.

Study selection

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 extraction

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, …

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  • Source of funding: not stated.

  • For correspondence: Dr H M Krumholz, Yale University School of Medicine, New Haven, CT, USA. harlan.krumholz{at}

  • Abstract and commentary also published in ACP Journal Club