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Drugs of the Month
Joint Commission is having us monitor patients and the use of beta blockers. Here is an interesting study on the intra-operative use of beta blockers. The second paragraph is a trial of a new antihypertensive. Fewer MIs but more deaths with perioperative beta blockers A new study questions the use of perioperative beta blockers before non-cardiac surgery. In a large trial, patients were randomized to receive either metoprolol or placebo postoperatively for 30 days. All of them had a history of coronary disease, stroke, or peripheral vascular disease; recent hospitalization for heart failure; major vascular surgery; or any three of seven other criteria outlined in the protocol. The metoprolol group had fewer myocardial infarctions but more stroke and deaths than the placebo group. This finding contradicts several small trials from the late 1990s, which found perioperative beta-blocker use lowered the incidence of cardiac ischemic complications associated with non-cardiac surgery. www.thelancet.com/journals/lancet/article/PIIS0140673608606017/abstract _ Positive results halt trial of combination antihypertensive drug A clinical trial was stopped early when the drug Lotrel proved to be 20% more effective in preventing myocardial infarction and other cardiovascular problems than an angiotensin-converting enzyme (ACE) inhibitor and diuretic combination. Lotrel combines benazepril hydrochloride (an ACE inhibitor) with amlodipine (a calcium channel blocker). In the study, 10,700 volunteers took either Lotrel or a singlepill combination of benazepril and the diuretic hydrochlorothiazide. After 6 months, both combination drugs helped 73% of subjects reach goal blood pressure. Researchers believe the trial may lead to a change in national hypertension treatment guidelines. http://www.pharma.us.novartis.com/newsroom/press-release.jsp?PRID=2059 _ |