Preoperative treatment with {beta}-blockers is associated with elevated postoperative mortality and cardiac morbidity in patients with uncomplicated hypertension undergoing non-cardiac surgery

Commentary on: Jørgensen ME, Hlatky MA, Køber L, et al.. β-Blocker-associated risks in patients with uncomplicated hypertension undergoing noncardiac surgery. JAMA Intern Med 2015;175:1923–31. Context The role of β-blockers in preventing cardiovascular complications of non-cardiac surgery is controversial. Early enthusiasm was dampened by accumulating trial data and concerns about the scientific validity of several trials. When studies with uncertain validity are excluded, meta-analyses of randomised trials show that perioperative β-blockers (started within 1 day before surgery) prevent postoperative myocardial infarction (MI), but increase the risks of stroke and death.1 This Danish nationwide cohort study evaluated the association of long-term preoperative β-blocker treatment with mortality and cardiac morbidity after non-cardiac surgery in patients with uncomplicated hypertension. Methods Population-based healthcare databases were used to conduct a retrospective cohort study of adults who had uncomplicated hypertension (no cardiovascular, renal or liver disease), were prescribed two or three...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: Liver disease, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Chemotherapy, Ischaemic heart disease Aetiology/Harm Source Type: research