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Related Experiment Videos

Beta-adrenergic blocking agents and intermittent claudication: systematic review.

Ritsuko Miyajima1, Kazumi Sano, Hisahiro Yoshida

  • 1Course of Clinical Pharmacy, Graduate School, Meiji Pharmaceutical University, Kiyose City, Tokyo 204-8588, Japan. tu6050@std.my-pharm.ac.jp

Yakugaku Zasshi : Journal of the Pharmaceutical Society of Japan
|November 2, 2004
PubMed
Summary
This summary is machine-generated.

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Beta-blockers may worsen walking distance for intermittent claudication (IC) patients, but do not significantly affect other key measures. Current package insert precautions for beta-blockers in IC patients are not supported by evidence.

Area of Science:

  • Cardiology
  • Pharmacology
  • Vascular Medicine

Background:

  • Beta-adrenergic blocking agents (beta-blockers) are commonly prescribed, but their use in patients with intermittent claudication (IC) has been debated.
  • Contradictory information exists in past reports and package inserts regarding the safety and efficacy of beta-blockers for IC patients.

Purpose of the Study:

  • To systematically review and meta-analyze the effects of beta-blockers on patients with intermittent claudication (IC).
  • To clarify discrepancies in existing literature and clinical guidelines concerning beta-blocker use in IC.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Included trials compared beta-blockers against placebo or untreated controls in IC patients.

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  • Primary endpoints: maximal walking distance and time; Secondary endpoints: ankle-brachial index (ABI) and calf blood flow.

    • Main Results:

    • Meta-analysis revealed a significant worsening in maximal walking distance (SMD -0.31) and initial claudication distance (SMD -0.39) with beta-blocker use.
    • No significant differences were observed in maximal walking time, time to claudication onset, resting ABI, resting calf blood flow, or post-exercise calf blood flow.
    • Limited data on ABI suggests beta-blockers do not worsen this measure.

    Conclusions:

    • Beta-blocker administration in IC patients is associated with a significant decrease in walking distances.
    • Current evidence does not support the need for specific "precautions" in package inserts regarding beta-blockers for IC patients.
    • Reluctance to prescribe beta-blockers solely due to the presence of IC is inappropriate.