Study raises concern about the use of beta blockers for all heart patients

Jul 28 2005

Doubt has been cast on the popular practice of giving most heart patients drugs that reduce the heart's workload before and after major surgery, after new research has raised concerns about it.

Medical guidelines recommend giving beta blocker pills to people at high risk of heart problems if they are undergoing non-cardiac surgery, but hospitals however, routinely prescribe the drugs to most heart patients, even those at lower risk of complications, who are having an operation.

Now new research has found that low-risk patients given the drugs, were significantly more likely to die.

In this, the first observational study to look at how these drugs affect people with varying heart risk factors, supports the idea that beta blockers, which decrease the force of the heart's pumping action, should continue to be given to high-risk patients who have surgery.

It is common practice to use beta blockers to treat high blood pressure and various heart problems and to help prevent complications in heart attack survivors.

In this study, researchers led by Dr. Peter Lindenauer of Baystate Medical Center in Springfield, Mass., analyzed medical records of about 664,000 patients with a history of heart-related problems, who were having non-cardiac surgery in 2000 and 2001.

A sample of that population was examined by doctors, and they found that low-risk patients, who received beta blockers had a 43 percent increased risk of death, but beta blocker use was associated with a reduced risk of death in high-risk patients.

According to specialists, these two ongoing randomized trials, of gold standard in scientific research, should help to determine whether beta blockers pose any risk to low-risk patients.

Dr. Don Poldermans of the Erasmus Medical Center in Rotterdam, says in an accompanying editorial, that until the studies are completed, doctors should continue beta-blocker therapy in low-risk patients.

The findings are reported in the current edition of New England Journal of Medicine.