Navigation Links
Beta Blockers Raise Stroke, Death Risk After Surgery
Date:5/13/2008

Experts note doses of the blood-pressure drugs given in the study were probably too high

TUESDAY, May 13 (HealthDay News) -- Patients who received the blood pressure-lowering drugs known as beta blockers after having non-cardiac surgery were at higher risk of dying or having a stroke, a new Canadian study found.

However, the patients receiving the medications were less likely to have a heart attack, according to the report in the May 13 online issue of The Lancet.

"For a decade now there are guidelines saying you should give beta blockers to people having non-cardiac surgery," said lead researcher Dr. P.J. Devereaux, an assistant professor in the Department of Clinical Epidemiology and Biostatistics at McMaster University in Hamilton, Ontario.

The reason for giving beta blockers is that surgery increases the heart's need for oxygen and beta blockers help reduce blood pressure and heart rate, reducing strain on the heart, Devereaux explained.

Around the world, an estimated 100 million people have major non-cardiac surgery each year, so the finding could have serious consequences for many patients, Devereaux noted.

"In the last decade, even if only 10 percent of patients undergoing non-cardiac surgery were given beta blockers, that means 100 million people were given beta blockers, and that means 800,000 people died unnecessarily and a lot of people suffered a major stroke because they were given a beta blocker," Devereaux said.

In the study, 8,351 patients at 190 hospitals across 23 countries who were at risk for atherosclerotic disease [hardening of the arteries] and undergoing non-cardiac surgery were randomly selected to receive a beta blocker or a placebo. The beta blocker was given two to four hours before surgery, and continued for 30 days after the procedure.

The researchers found that patients receiving beta blockers were 16 percent less likely to have died from heart disease, compared with those receiving a placebo. In addition, those taking a beta blocker were 27 percent less likely to have a heart attack than patients receiving a placebo.

But, more people taking a beta blocker died than those taking a placebo. In fact, patients taking a beta blocker had a 33 percent increased risk of dying compared with patients taking a placebo.

Also, there were more strokes among people taking a beta blocker than among patients receiving a placebo. Those receiving the beta blocker had double the risk of suffering a stroke compared with patients receiving a placebo, the researchers reported.

The most likely explanation for the increase in deaths and stroke among those taking beta blockers was that these patients could go into shock if their blood pressure were too low, a not uncommon complication of surgery, Devereaux said. "If they were on the beta blockers they were in big trouble, and [it] increased their likelihood of dying or suffering a stroke," he said.

Devereaux doesn't think reducing the risk of heart attack is worth increasing the risk of stroke or death. "I don't think most patients would be willing to accept the excess death and excess stroke for preventing a heart attack," he said.

Using a beta blocker to prevent heart attacks in these patients is not the right strategy, Devereaux said. "If we are causing so much harm to prevent heart attacks, we need to find another solution which will prevent these events, but not have the same risk."

One expert thinks that the doses of beta blockers given in the trial were too high.

"The increase in hypotension [low blood pressure] and resulting strokes and cardiovascular deaths may be a result of this overly aggressive dosing rather than perioperative beta blocker therapy in general," said Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles.

"While further studies of other beta blockers and dosing regimens for perioperative use are still needed, the rapid up-titration to high dose of a beta blocker regimen employed in this study should be avoided," Fonarow said.

Another expert thinks that if beta blockers are given cautiously, the dangers found in the study can be greatly reduced.

"We don't want people to misinterpret this study," said Dr. Lee A. Fleisher, chair of the Department of Anesthesiology and Critical Care at the University of Pennsylvania School of Medicine, and author of an accompanying editorial in the journal. "The study did not say anybody who is on beta blockers should stop them."

Fleisher agrees that starting beta blockers the morning of surgery with high doses is not a good way to go. "That type of protocol is not good," he said.

More information

For more on beta blockers, visit the American Academy of Family Physicians.



SOURCES: P. J. Devereaux, M.D., assistant professor, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario; Lee A. Fleisher, M.D., chair, Department of Anesthesiology and Critical Care, University of Pennsylvania School of Medicine, Philadelphia; Gregg C. Fonarow, M.D., professor, cardiology, University of California, Los Angeles; May 13, 2008, The Lancet, online


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

Related medicine news :

1. Scripps scientists find calcium channel blockers help normalize lysosomal storage disease cells
2. Women are treated less frequently than men with statins, aspirin and beta-blockers
3. New review suggests caution on drugs to raise good cholesterol
4. Antioxidant Supplements May Raise Womens Skin Cancer Risk
5. Acrylamide Wont Raise Breast Cancer Risk
6. The Philadelphia Walk Now for Autism Expected to Draw 10,000 Walkers and Raise $1 Million to Help Find Answers About the Nations Fastest-Growing Developmental Disorder
7. BlueCare(R) Family Plan, a HUSKY Health Plan from Anthem Blue Cross and Blue Shield in Connecticut, Raises Awareness, Funds and Diapers for New Haven Diaper Bank
8. Mercedes-Benz Special Edition C350 Sport Sedan to Raise $1 Million for Saks Fifth Avenues KEY TO THE CURE
9. Care reforms raise concerns over patient access to GP services
10. The Will and Jada Smith Family Foundation and Maybelline Join Forces With the Lupus Foundation of America for a Star-studded Gala to Raise Awareness for Lupus
11. Computer models help raise the bar for sporting achievement
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Beta Blockers Raise Stroke, Death Risk After Surgery
(Date:6/24/2016)... ... ... a crisis. Her son James, eight, was out of control. Prone to extreme mood shifts ... upset him, he couldn’t control his emotions,” remembers Marcy. “If there was a knife ... and say he was going to kill them. If we were driving on the ...
(Date:6/24/2016)... ... June 24, 2016 , ... Dr. Amanda Cheng, ... treatment. Dr. Cheng has extensive experience with all areas of orthodontics, including robotic ... osteogenic orthodontics. , Micro-osteoperforation is a revolutionary adjunct to orthodontic treatment. It ...
(Date:6/24/2016)... ... 2016 , ... People across the U.S. are sharpening their pencils and honing ... contest in which patients and their families pay tribute to a genetic counselor by ... Society of Genetic Counselors (NSGC) Annual Education Conference (AEC) this September. , In ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... Investment Group (TGIG), has initiated cultivation and processing operations at its production facility, ... Pahrump, Nevada. , Puradigm is the manufacturer of a complete system of proactive ...
(Date:6/24/2016)... ... 24, 2016 , ... Venture Construction Group (VCG) sponsors Luke’s Wings ... 20th at the Woodmont Country Club at 1201 Rockville Pike, Rockville, Maryland, 20852. ... service members that have been wounded in battle and their families. Venture Construction Group ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 ... CAPR ), a biotechnology company focused on the ... announced that patient enrollment in its ongoing randomized ... has exceeded 50% of its 24-patient target. Capricor ... the third quarter of 2016, and to report ...
(Date:6/23/2016)... -- Astellas today announced the establishment of Astellas Farma Colombia (AFC), a new affiliate with operations headquartered in ... . ... ... ... Astellas is ...
(Date:6/23/2016)... 2016  Experian Health, the healthcare industry ... patient payment and care experience, today announced ... and services that will enhance the breadth ... These award-winning solutions will enable healthcare professionals ... in an ever-changing environment and redefine front-office ...
Breaking Medicine Technology: