title: Cross-sectional survey of beta-blockers use in primary and secondary care for patients with arterial disease.
abstract: Beta-blockers reduce mortality in ischaemic heart disease and, when given perioperatively, in vascular surgery. We investigated the use of and attitudes towards beta-blockers by British vascular surgeons and primary care physicians (GPs). We performed a cross-sectional postal survey by questionnaire sent to 367 GPs and 397 members of the Vascular Surgical Society. Specific questions related to beta-blockers use and indications. Two hundred and thirty-four GPs, 95 full-time vascular surgeons (VS) and 137 general surgeons (GS) with a vascular interest responded. Thirty-eight percent of VS and 16% of GS often or always used perioperative beta-blockade (p<0.001). Common indications were ischaemic heart disease (39.2%), hypertension (30.6%), arrhythmia (16.3%) and myocardial protection (6.9%). Sixty-eight percent of VS and 42% of GS would prescribe beta-blockers to patients with occlusive arterial disease (p < 0.001). Common indications were ischaemic heart disease (39.6%), hypertension (29.2%) and arrhythmia (13.3%). Of those who would not prescribe beta-blockers in occlusive arterial disease, 65% felt that beta-blockers were contraindicated in this condition. GPs widely regarded occlusive arterial disease as a contraindication to beta-blockade. Beta-blockers are underused by GPs and GS especially, perhaps because of a perceived risk of side effects in patients with occlusive arterial disease. Further evidence is needed on the effect of beta-blockade on quality of life of patients with arterial disease.
authors.affiliation: Department of Surgery, Countess of Chester Hospital, Chester, UK.
authors.forename: F
authors.initials: F
authors.lastname: Torella
authors.forename: I
authors.initials: I
authors.lastname: Khattak
authors.forename: P R
authors.initials: PR
authors.lastname: Edwards
authors.forename: L
authors.initials: L
authors.lastname: de Cossart
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000458:organization & administration; D019538:Health Care Surveys; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D000319:Adrenergic beta-Antagonists