BMJ  2005;331 (22 October), doi:10.1136/bmj.331.7522.0-a

Choose long acting blockers for elderly surgical patients

Patients older than 65 who undergo elective surgery are less likely to have a myocardial infarction or die if they receive atenolol rather than metoprolol. The effect extends to other long acting and short acting blockers. A population based, retrospective cohort study by Redelmeier and colleagues (p 932) included more than 37 000 consecutive elderly patients undergoing surgery in acute care hospitals in Ontario, Canada over a decade. The results suggest that switching from short acting to long acting blockers may prevent one myocardial infarction or death for every 165 patients, with no increase in other common perioperative complications.

Credit: JAMES-KING HOLMES/SPL

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