cardiovascular disease

Could Perioperative Beta-Blockers Increase Cardiovascular Risk?

Antihypertensive treatment with a beta-blocker is associated with increased risk of major adverse cardiovascular events and mortality in patients undergoing noncardiac surgery.

In order to gauge the risk of adverse events associated with long-term beta-blocker therapy during noncardiac surgery, researchers conducted a study of in-hospital records and out-of-hospital pharmacotherapy in a Danish cohort of 55,320 patients.1
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All patients were treated with at least 2 antihypertensive drugs, including beta-blocker, thiazides, calcium antagonists, or renin-angiotensin system inhibitors, and underwent noncardiac surgery between 2005 and 2011.

Overall, 30-day incidence of major adverse cardiovascular events and mortality in the 14,644 patients treated with beta-blockers was 1.32% and 1.93%, respectively, compared with 0.84% and 1.32%, respectively, in the 40,676 patients treated with other drugs.  

"This association was seen irrespective of the antihypertensive drug combination and was consistent across subgroups. This observation may suggest that perioperative management of patients with hypertension should receive specific attention in clinical practice and future guidelines, but additional randomized clinical trials on this question may be warranted," they concluded.2

—Michael Potts

References:

  1. Jorgensen ME, Hlatky MA, Kober L, et al. β-blocker–associated risks in patients with uncomplicated hypertension undergoing noncardiac surgery. JAMA Intern Med. October 5, 2015 [epub ahead of print]. doi:10.1001/jamainternmed.2015.5346.
  2. JAMA. Antihypertensive β-blockers may increase cardiovascular risks in surgical patients [press release]. http://www.eurekalert.org/pub_releases/2015-10/tjnj-am100115.php.