In the known atherothrombotic disease and the risk factors alone cohorts , - blocker use was not associated with lower ischemic outcomes , whereas a trend toward a higher risk of stroke ( 3.5 % versus 1.5 % ; hazards ratio , 2.13 ; 95 % confidence interval , 0.92-4 .92 ; P = 0.079 ) was observed in the risk factors alone cohort .