Heart drugs may cause harm - researcher

June 22, 2007

DRUGS given to patients after surgery to prevent heart attacks and strokes could actually cause complications, an Australian researcher says.

The drugs known as beta blockers and statins are administered to about 100 million adults around the world each year before, during and after surgery on any part of the body except the heart.

The drugs prevent heart complications and help lower blood pressure.

But Stephen Bolson, an anaesthetist and associate professor of patient safety at the University of Melbourne, said about 1 per cent of such patients were at risk of cardiac complications such as heart attacks and strokes, and about one in four would die each year.

Writing in the latest edition of the British Medical Journal (BMJ), Prof Bolson said the benefits of using the drugs after surgery were unclear at best, and at worst could cause complications.

Prof Bolson said he wrote an editorial for BMJ two years ago on the subject and his current research called into question the effectiveness of the drugs.

"In the late 1990s, there was some rather misleading and probably disingenuous research that was undertaken in America which suggested that beta blockers were useful for patients undergoing non-cardiac surgery to prevent cardiac complications," Prof Bolson said.

"But it wasn't really well-designed research and more recent evidence has continued to call that into question."

Prof Bolson said two studies from Denmark and the UK since then had reported no drop in the rates of death or several other serious complications, such as heart attack, heart failure, and stroke 30 days after surgery in patients receiving beta blockers.

Another study found no benefit six months after surgery, and a trial at the moment had so far not reported any beneficial effects, he said.

"If you are going to use these drugs routinely, you will end up treating more patients than you would otherwise for these complications of low blood pressure and low heart rate," he said.

"We know that low blood pressure can cause complications in the peri-operative (post-operative) period."

But one of the early US studies showed there could be also be complications in patients who had been on beta blockers and then suddenly stopped taking them, he said.

"These drugs are not cheap and treating their complications also incurs added expense and we think there is a lot of expensive treatment going on with no good evidence for it.

"If you are already on those drugs, then you should continue during your surgical course.
"But if you are not on them, there is no evidence that starting them will help you at all."

Article from: AAP

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