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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
14:52

Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication

Published on: December 11, 2013

Beta blockers for peripheral arterial disease

Sharath Chandra Vikram Paravastu1, Derick Mendonca, Anthony Da Silva

  • 1Department of Vascular Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, Lancashire, UK, M13 9WL.

The Cochrane Database of Systematic Reviews
|October 10, 2008
PubMed

Insights

Beta blockers do not appear to worsen walking distance for individuals with intermittent claudication. However, caution is advised due to limited large-scale trial data on beta blockers in peripheral arterial disease.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Pharmacology

Background:

  • Beta blockers are standard for coronary artery disease (CAD).
  • Their use in patients with co-occurring intermittent claudication (IC) is debated due to potential negative effects on peripheral circulation.
  • This controversy stems from concerns that beta blockers may exacerbate IC symptoms.

Purpose of the Study:

  • To systematically evaluate the impact of beta blockers on walking capacity and peripheral hemodynamics in patients with peripheral arterial disease (PAD).
  • Specifically, to quantify effects on maximum walking distance, claudication distance, calf blood flow, calf vascular resistance, and skin temperature.

Main Methods:

  • A comprehensive search of randomized controlled trials (RCTs) was conducted using the Cochrane Peripheral Vascular Diseases Group Trials Register and CENTRAL.
  • Included RCTs compared selective or non-selective beta blockers against placebo in PAD patients.
  • Primary outcomes included walking distances and times; secondary outcomes involved calf hemodynamics and skin temperature.

Main Results:

  • Six RCTs involving 119 patients were analyzed, testing beta blockers like atenolol, propranolol, pindolol, and metoprolol.
  • No statistically significant adverse effects on walking distance or hemodynamic parameters were observed.
  • No adverse events related to beta blocker use were reported in the included studies.

Conclusions:

  • Current evidence does not support the notion that beta blockers negatively impact walking distance in individuals with intermittent claudication.
  • Despite the lack of evidence for harm, the limited number of large trials suggests cautious use of beta blockers when clinically indicated for PAD patients.
Abstract

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