Beta blockers for peripheral arterial disease.
OBJECTIVE
To quantify the potential harm of beta blockers in patients with peripheral arterial disease.


METHODS
All randomised controlled trials (RCTs) comparing beta blockers with placebo for the outcomes of claudication and maximal walking distance and time, calf blood flow, vascular resistance and skin temperature were searched using the Cochrane Controlled Trials Register, PubMed and CINAHL. Trials comparing different types of beta blockers were excluded.


RESULTS
Six RCTs fulfilling the above criteria, with a total of 119 patients, were included. The beta blockers studied were atenolol, propranolol, pindolol and metoprolol. None of the trials showed a statistically significant worsening effect of beta blockers on the outcomes measured. There were no reports of any adverse events with the beta blockers studied.


CONCLUSIONS
Currently, there is no evidence to suggest that beta blockers adversely affect walking distance in people with intermittent claudication. Beta blockers should be used with caution if clinically indicated, especially in patients with critical ischaemia where acute lowering of blood pressure is contraindicated.
Manchester Royal Infirmary, Manchester, UK. sharathparavstu@googlemail.com
S C V
SC
Paravastu
D A
DA
Mendonca
A
A
da Silva
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy / Q000503:physiopathology; D016491:Peripheral Vascular Diseases / Q000188:drug therapy* / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014655:Vascular Resistance / Q000187:drug effects
D000319:Adrenergic beta-Antagonists