Surgery alert – Elective surgery Beta-blocker shocker

Nevertheless, regardless of the type, beta-blockers in general bring their own set of problems to the table. For example, stopping the use of these drugs can often trigger the same things brought about by surgery: heart failure and death.

Recent stoppers of beta-blockers have long been known to have an increased relative risk of coronary heart disease. Hypertensive patients with no previous history of such disease were found to have a ‘withdrawal syndrome’ – characterised by angina and heart attack – immediately after stopping beta-blockers (J Am Med Assoc, 1990; 263: 1653-7; BMJ, 2005; 331: 932).

When eight patients taking metoprolol for essential hypertension had it abruptly withdrawn and replaced by a placebo, the results included increases in resting heart rate and high blood pressure. However, tapering off the beta-blocker (50 mg/day for 10 days) before stopping it did not prevent these cardiovascular changes (Clin Pharmacol Ther, 1982; 31: 8-15).

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