Side Effects of Beta Blockers May Increase Risk of Stroke After Surgery: Study

Researchers indicate that more studies are needed to determine how to safely use the hypertension drugs before surgery, especially among minorities.

The findings of a new study suggest that a commonly prescribed class of medications, known as beta blockers, may increase the risk of stroke when they are taken before surgery, particularly among Black and Latino patients.

Beta blockers include widely used medications, such as Lopressor, Toprol, Tenormin and others, which help treat various cardiovascular conditions by relaxing blood vessels and slowing the patient’s heart rate.

These medications are commonly prescribed to treat high blood pressure, as well as heart arrhythmia, and are also prescribed to patients who have recently suffered a heart attack, to help improve survival rates and prevent further complications.

However, in findings presented last month at the American Society of Anesthesiologists annual meeting, researchers from Montefiore Medical Center in New York have added new research to a growing body of evidence that has linked the side effects of beta blockers to stroke risks following surgical procedures, indicating that these risks are particularly acute for Black and Latino patients, who are prescribed the drugs at higher rates than white patients.

The study was led by Dr. Maira Rudolph, involving a review of the records of nearly 206,000 patients who underwent non-cardiac surgeries at two hospitals in Boston and New York City from 2005 to 2021.

The findings indicate any use of beta blockers before surgery increased the patient’s risk of suffering a stroke after the procedure. This included patients who began using beta blockers within 30 days before their surgery and patients who had used beta blockers for a year before their surgery.

Among Black and Latino patients, beta blockers attributed to 7% and 2% of the increased risk of stroke respectively. Additionally, data indicates Black and Latino patients were more likely to be prescribed beta blockers by their doctors, compared to white patients, and were more likely to have a stroke than white patients.

Researchers said there was no evidence indicating Black or Latino patients were sicker or had more progressed health conditions compared to white patients. So that factor did not account for the difference in prescribing or risk.

Prior research has shown that beta blockers given within two to four hours before surgery increased a person’s risk of stroke and death. The findings of the new study build on that data, showing that any beta blockers taken up to one year before surgery can also contribute to that risk.

Rudolph’s team concluded that simply discontinuing beta blockers isn’t helpful either, since they do provide beneficial effects that can help protect the heart as well. Therefore, they called for more research into how to properly use beta blockers before surgery for patients who need them, while also lowering their risk of stroke and death.

Prior research has shown beta blocker use contributes to a number of other heart and blood flow-related side effects. In a study published earlier this year, researchers found that beta blockers did not help decrease the person’s risk of having another heart attack. Another study, published in 2019, found that among patients with a condition known as “stiff heart,” which affects roughly half of all heart attack patients, taking beta blockers increased the risk of heart failure.