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[Intermittent claudication and beta-blockaders. An unfortunate combination?]

A K Andreassen1, L Gullestad, R Bjørnerheim

  • 1Medisinsk avdeling B, Rikshospitalet, Oslo.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|February 28, 1995
PubMed
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Beta-adrenergic blockers do not worsen walking capacity in patients with peripheral arterial disease. Evidence suggests these drugs are safe for managing intermittent claudication when other conditions require them.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Beta-adrenergic blockers were historically contraindicated in peripheral arterial disease (PAD) due to concerns about worsening intermittent claudication.
  • Previous reports suggested potential adverse effects on walking distance and peripheral circulation.

Purpose of the Study:

  • To evaluate the safety and efficacy of beta-adrenergic blockers in patients with intermittent claudication.
  • To review randomized controlled trials comparing beta-blockers with placebo or alternative medications.

Main Methods:

  • Systematic review and analysis of published randomized controlled trials (RCTs).
  • Comparison of outcomes, including walking distance and peripheral blood flow, between beta-blocker and placebo/alternative drug groups.

Main Results:

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  • Most RCTs found no significant reduction in walking distance or impairment of peripheral flow with beta-blockers compared to placebo.
  • One study noted an adverse effect, but this involved a beta-blocker with intrinsic sympathomimetic activity.
  • Alternative drugs showed limited benefits in the few trials that included them.

Conclusions:

  • There is a lack of evidence to support the avoidance of beta-blockers in mild to moderate intermittent claudication.
  • Beta-blockers can be safely used if they are the optimal therapy for co-existing atherosclerotic conditions.
  • Current evidence does not support the contraindication of beta-blockers in PAD patients experiencing claudication.