The ACC/AHA updated the recommendations for peri-operative beta blockers in non-cardiac surgery patients. The only Class I recommendation is to continue beta blockers in those already on them. Class IIa include starting beta blockers on those undergoing vascular surgery (with known CAD, ischemia, or >1 risk factor*), or intermediate risk surgery with > 1 risk factor. Class IIb (uncertainty of benefit) for those undergoing intermediate risk with <1 risk factors or vascular surgery with 0 risk factors. They emphasizethat beta blockers should be titrated to goal BP/HR effect. (*risk factors = h/o ischemia, h/o CHF, h/o CVA, h/o DM, or h/o creatinine>2mg/dL) (guideline)
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