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

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Aetiology/Harm
Cohort study
Preoperative treatment with β-blockers is associated with elevated postoperative mortality and cardiac morbidity in patients with uncomplicated hypertension undergoing non-cardiac surgery
  1. Duminda N Wijeysundera1,2,3
  1. 1Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
  2. 2Department of Anesthesia, Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada
  3. 3Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to : Dr Duminda N Wijeysundera, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8; d.wijeysundera{at}utoronto.ca
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http://dx.doi.org/10.1136/ebmed-2016-110395

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    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.OpenUrlPubMed

    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 …

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    Footnotes

    • Contributors DNW prepared the first draft of this paper, revised it for important intellectual content, and is the guarantor.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.

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