Beta-blockers and risk for upper GI bleed

  • Ther Adv Gastroenterol

  • Jenny Blair, MD
  • Clinical Essentials
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Takeaway

  • Beta-blockade was not associated with altered risk for upper gastrointestinal bleeding (UGIB) in this case-control study.

Why this matters

  • Results from several small studies have suggested beta-blockers protect against UGIB.

Key results

  • Comorbidities and medication use were higher among patients vs control patients.
  • 484 patients taking beta-blockers experienced UGIB.
  • Ever and current beta-blocker use was higher among patients vs control patients (26.9% vs 18.1% and 13.6% vs 9.1%, respectively).
  • Crude OR for UGIB among beta-blocker users vs nonusers was 1.70.
  • After adjustment for confounders, ever beta-blocker use was not associated with UGIB (OR, 1.10; 95% CI, 1.00-1.21).
  • In subgroup analysis, the association with UGIB remained neutral for selective vs nonselective beta-blockers, varying degrees of comorbidity, and recency and dosage of beta-blocker.

Study design

  • Registry-, population-based, case-control study comparing use of beta-blockers among patients with or without UGIB.  
  • Patients (n=3571): residents of 1 county admitted to hospital between 1995 and 2006 with UGIB (excluding gastric varices and patients with liver disease).
  • Control patients (n=35,582): 10 randomly selected age- and sex-matched people from same registries.
  • All cases manually validated.
  • Outcome: OR for UGIB among beta-blocker users vs nonusers.
  • Funding: None.

Limitations

  • Confounding lifestyle factors and over-the-counter medications not accounted for.