Beta-blockers and peripheral arterial disease

Journal of Clinical and Basic Cardiology 2001; 4 (1): 15-16

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Keywords: Betablocker,  periphere arterielle Verschlusskrankheit,  Raynaud-Syndrom,  schmerzfreie Wegstrecke,  beta-blocker,  pain-free walking distance,  peripheral arterial disease,  Raynauds phenomenon

In patients with large vessel peripheral arterial disease the excess risk of death is due to an increase in deaths from cardiovascular disease, especially coronary heart disease. Beta-blockers are one of the most powerful drugs in reducing overall cardiovascular mortality. However, beta-blockers have been considered to be relatively contraindicated in patients with concomitant intermittent claudication because of the suggested blockade of beta2-receptor mediated skeletal muscle vasodilatation. Pooled estimate of overall treatment effect in meta-analysis did not show any significant effect of beta-blockers on pain-free walking distance or maximal walking distance. This finding should be drawn with caution to patients with Raynaud's phenomenon or severe peripheral disease, because in these patients individual responses are less predictable than those from study populations. Nevertheless, beta-blockers should be given to patients suffering from peripheral occlusive disease who are at high risk for cardiovascular disease because of its well documented effect on reducing overall cardiovascular mortality. J Clin Basic Cardiol 2001; 4: 15-16.