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Questions Continue About Using Beta Blockers Before Surgery
Date:10/20/2008

ry will not do as well," Itani said. "Giving the drugs without achieving the full potential might be dangerous."

But the study indicates that the guidelines "need to be revisited," said Dr. Jeffrey H. Peters, chief of surgery at the University of Rochester, New York.

"This paper adds to a growing body of evidence suggesting that the routine use of beta blockers to reduce cardiac morbidity in surgery needs to be reconsidered," Peters said.

Unlike the POISE study, which was carefully designed with controls built in, the Boston study was retrospective, comparing 238 people given beta blockers before surgery with 480 who underwent surgery at the same center without being given the drugs, Peters noted.

"This is a retrospective study that is far from definitive, but it suggests that we should reconsider," he said.

"We recommend beta blockers for high risk patients, but we currently use them less and less," Peters said. He does not give beta blockers before surgery to people with no major risk factors for heart disease, such as diabetes or high blood pressure, he said.

Another paper published in the Oct. 28 issue of the Journal of the American College of Cardiology raises doubts about the use of beta blockers to control high blood pressure.

Analysis of data from nine controlled trials found a higher incidence of deaths, heart attacks, strokes and heart failure for people whose heart rate was lowered by beta-blocker treatment, said the report from cardiologists at Columbia University College of Physicians and Surgeons.

More information

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



SOURCES: Kamal Itani, M.D., professor, surgery, Boston University; Jeffrey H. Peters, M.D., chief, surgery, University of Rochester, N.Y.; Oc
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