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Diuretics and Sudden Cardiac Death
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
In their recent article, Hoes and colleagues [1] found that although overall mortality decreased, the rate of sudden death increased among patients receiving β-blockers. It would be instructive to divide the β-blocker group and determine the attributable risk for each of the β1 selective and the nonselective β-blocker groups. In a recent editorial, Brown [2] discusses the argument for using nonselective β-blockade in patients without diabetes. He asserts that the population of β2 receptors in the heart can contribute equally to arrhythmias (compared with β1 receptors), which can result in sudden death before a patient reaches the hospital. Selective β1 blockade also causes the β2 receptor to be paradoxically more sensitive to adrenaline [3, 4]. Thus, using a β1 selective β-blocker may leave the cardiac β2 receptor more vulnerable to arrhythmias and thus may induce sudden death. If the specific type of β-blocker can be determined from this study, it may help us to understand for whom which drug may be most appropriate.
David S. Buck, MD, MPH
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
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