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See Latest ArticlesACC, AHA Update Guidelines for Beta Blockers
American Family Physician, 12/17/09
The use of beta blockers in patients undergoing noncardiac surgeries should be initiated well in advance of procedures and titrated up as blood pressure and heart rate allow, according to an update of guidelines from the American College of Cardiology, or ACC, and the American Heart Association, or AHA. The organizations said evidence suggests that when possible and where indicated, beta blockers should be started days to weeks before elective surgery. Furthermore, the dose should be titrated to achieve adequate heart rate control to increase the likelihood that the patient will receive the benefit of the medication while minimizing the risks of hypotension and bradycardia. The ACC and AHA advise that beta blockers are reasonable to consider in patients at high risk for heart attacks or other cardiac complications because of abnormal stress test results or known coronary artery disease who undergo vascular surgery; and high–risk patients undergoing intermediate risk surgery or in those with multiple risk factors for complications, such as diabetes, a history of heart failure or significant kidney disease, who undergo vascular surgery.
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