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
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