Navigation Links
Beta Blocker Use Questioned in Non-Heart Surgery
Date:11/10/2008

Increased risk of stroke a major issue in analysis of 33 research projects

MONDAY, Nov. 10 (HealthDay News) -- An analysis of 33 studies on drugs known as beta blockers has concluded that they are not useful in any surgical procedure other than heart surgery. In fact, using beta blockers for non-coronary surgery may actually increase the risk of stroke, the scientists say.

The researchers who conducted the study -- known as a meta-analysis -- recommend that the guidelines committees of both the American College of Cardiology and the American Heart Association "soften" their recommendations that beta blockers be used to prevent surgical complications in non-coronary operations.

"Our study says that if you look at the overall picture, do a meta-analysis, studies that are not particularly well-done come to the conclusion that they are useful," said Dr. Franz Messerli, professor of medicine at Columbia University and an author of a report published online by The Lancet to coincide with the annual heart meeting now underway. "But if you look at the high-quality studies, there are distinctly more strokes with beta blockers." Beta blockers are drugs that inhibit adrenaline and slow the nerve impulses to the heart. They can also be used to treat irregular heartbeat, known as arrhythmia.

The meta-analysis did show a 35 percent reduced risk of heart attacks and a 64 percent reduction in less serious heart artery blockages among the more than 12,000 participants in all the studies where beta blockers were prescribed before surgery. But there was no overall reduction in total deaths, heart failure or deaths due to heart disease, and a doubled risk of nonfatal stroke.

Beta blocker usage was also associated with a high risk of bradycardia, low heart rate requiring medical treatment, which occurred in 1 of every 22 people getting beta blockers, and of lower blood pressure dangerous enough to require treatment.

In September 2008, researchers writing in the Journal of the American College of Cardiology concluded that beta blocker drugs don't prevent development of heart failure in people with high blood pressure and should not be used as first-line treatment for hypertension.

The increased risk of stroke, occurring in 1 of every 293 beta blocker recipients, is especially important, Messerli said. "Stroke is one of the most devastating complications of cardiovascular disease," he said. "For that reason, we would be very reluctant to use beta blockers in noncomplicated patients."

There is a presurgical role for beta blockers in many cases, Messerli said. "If a patient has coronary artery disease, he or she should certainly be on beta blockers," he said. "If they are on beta blockers already, they should remain on beta blockers. But if there is no particular cardiovascular risk, beta blockers should not be prescribed for noncardiac procedures."

Existing recommendations that call for routine use of beta blockers before surgery should be revised, Messerli said. "This is regarded as a quality measure for physicians," he said. "If they don't prescribe a beta blocker, it is considered to be falling short of a quality measure. Since the data are relatively soft, it certainly should not be a quality measure."

But an argument for use of beta blockers before surgery was made in an accompanying comment to the study by Dr. Don Poldermans, professor of medicine at Erasmus Medical Center in Rotterdam, the Netherlands. One major problem with studies showing difficulties when beta blockers were prescribed was that the doses were too high, Poldermans said.

"A low dose is safe, so why not use it?" Poldermans said, citing a study that he presented to the American Heart Association's annual scientific sessions, in New Orleans.

The study of 1,066 people who underwent surgery and were classified as being of intermediate risk of cardiovascular complications found that 2.1 percent of those getting a moderate daily dose of bisoprolol, a widely used beta blocker, suffered heart attacks or died of heart disease, compared to 6 percent of those not getting the beta blocker, Poldermans reported.

What might help decide the issue would be "a study to clarify dose and regimen" of beta blockers before surgery, he said. But such a study might be difficult to do, because the dangers of high-dose beta blockers are clear, Poldermans said.

"I would be very careful with high doses of beta blockers," he said. "There could be an increased risk of stroke. But a low dose is safe, so why take a high dose?"

More information

Learn why and how beta blockers are used from the Texas Heart Institute.



SOURCES: Franz Messerli, M.D., professor of medicine, Columbia University, New York City; Dan Poldermans, M.D., professor of medicine, Erasmus Medical Center, Rotterdam, the Netherlands; Nov. 11, 2008, The Lancet


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Questions Continue About Using Beta Blockers Before Surgery
2. Beta Blockers Help Hospitalized Heart Failure Patients
3. Beta Blocker May Shrink Infant Hemangiomas
4. Beta Blockers Raise Stroke, Death Risk After Surgery
5. Study Shows Increased Out-of-Pocket Expenses May Negatively Influence Initiation of TNF Blocker Therapy
6. Women are treated less frequently than men with statins, aspirin and beta-blockers
7. Venture Global Limited Introduces an Innovative Anti-Cellphone Radiation Sticker Named VEGO Power Blocker
8. Scripps scientists find calcium channel blockers help normalize lysosomal storage disease cells
9. FDA approves Bystolic, a novel beta blocker
10. Blood-vessel blocker aids cancer-killing virus
11. Beta Blocker Doesnt Help Children With Heart Failure
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Beta Blocker Use Questioned in Non-Heart Surgery
(Date:10/13/2017)... ... October 13, 2017 , ... Yisrayl Hawkins, Pastor and Overseer at The ... the most popular and least understood books in the Holy Scriptures, Revelation. The Book ... have baffled scholars for centuries. Many have tossed it off as mere rubbish, but ...
(Date:10/13/2017)... ... 2017 , ... “The Journey: From the Mountains to the Mission Field”: the ... in the Philippines. “The Journey: From the Mountains to the Mission Field” is the ... She has taught all ages and currently teaches a class of ladies at her ...
(Date:10/12/2017)... , ... October 12, 2017 , ... ... now treating sleep apnea using cutting-edge Oventus O2Vent technology. As many ... sleep disorder characterized by frequent cessation in breathing. Oral appliances can offer significant ...
(Date:10/12/2017)... , ... October 12, 2017 , ... IsoComforter, Inc. ( ... announced today the introduction of an innovative new design of the shoulder pad. ... you get maximum comfort while controlling your pain while using cold therapy. By utilizing ...
(Date:10/12/2017)... ... October 12, 2017 , ... Information about the ... to develop to enable prevention of a major side effect of chemotherapy in ... in pediatric patients. For cisplatin, hearing loss is FDA listed on-label as a ...
Breaking Medicine News(10 mins):
(Date:10/4/2017)... Oct. 4, 2017 OBP Medical ... illuminating medical devices, today announced regulatory approval from ... Agency (or Agência Nacional de Vigilância Sanitária (ANVISA)) ... cordless surgical retractor with integrated LED light source ... illumination and exposure of a tissue pocket or ...
(Date:10/2/2017)... 2017 Halo Labs announces the European launch of their ... HORIZON at MIBio 2017 in Cambridge, U.K ... matter in biopharmaceutical samples with unprecedented speed and sensitivity while using ... Backgrounded Membrane Imaging. ... subvisible particle analysis system ...
(Date:9/27/2017)... 27, 2017  Commended for their devotion to personalized service, ... as number one in the South Florida Business Journal,s 50 ... 5000 yearly list, the national specialty pharmacy has found its ... will soon be honored by SFBJ as the 2017 ... Set to receive his award in October, Bardisa said ...
Breaking Medicine Technology: