For patients who underwent noncardiac surgery, a two-drug antihypertensive treatment regimen with a beta-blocker was associated with an increased risk of perioperative major adverse cardiovascular events (MACEs) and all-cause mortality, according to research published in JAMA Internal Medicine.
Mads E. JØrgensen of Copenhagen University Hospital and his associates examined data from 671,242 surgeries performed in Denmark from 2005-2011; ultimately, 14,644 patients treated with beta-blockers and the 40,676 patients treated with other antihypertensive drugs (or 55,320 hypertensive patients using at least two antihypertensive drugs) were included in the analysis.
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The incidence of 30-day MACEs and mortality was 1.32% and 1.93%, respectively, in patients treated with beta-blockers, compared with 0.84% and 1.32%, respectively, in patients treated with other drugs only (both P less than .001).
The investigators also noted that patients over age 70, men, and patients undergoing acute surgery were at greater risk for MACEs.
“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,” the investigators wrote.
Read the full article in JAMA Internal Medicine (doi:10.1001/jamainternmed.2015.5346.).