A shocking new study claims that evidence does not support current guidelines for use of beta-blockers for patients having noncardiac surgery.
It says that the drugs are not associated with any significant reduction in the risk of all-cause mortality, cardiovascular mortality or heart failure.
In fact, it claims they show a doubling of risk for non-fatal stroke, and are also associated with a high risk (one in 22) of low heart rate and an even higher risk (one in 17) of low blood pressure.
The authors are Dr Sripal Bangalore, at Brigham and Women’s Hospital in Boston, US, and Professor Franz Messerli, at St Luke’s-Roosevelt Hospital and Columbia University College of Physicians and Surgeons in New York, who did a meta-analysis of 33 beta-blocker studies.
They say: “The beneficial effects were driven mainly by trials with a high risk of bias,” and conclude: “Beta blockers should not be routinely used for perioperative treatment of patients undergoing non-cardiac surgery unless patients are already taking them for clinically indicated reasons.
“The ACC/AHA guideline committee should soften their stance on perioperative beta blockade until definitive evidence shows clear benefits.”
Copyright Press Association 2008