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PJ Lama, S Agarwal, SS Plasner, SA Gollance, RD Fechtner; Frequency of Contraindications to the Use of Ocular Beta-blockers in Patients at a University General and Glaucoma Eye Clinic . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4077.
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Purpose: To ascertain prevalence of relative and absolute contraindications to ocular beta blockers (OBB) in 400 patients (two groups of 200 consecutive patients from a general eye clinic (GEC) and glaucoma clinic (GC)). Methods: Patient interview using a standardized questionnaire to identify beta blocker contraindications. Review of medical records and/or contact with the primary medical doctor to verify when needed. Absolute contraindications were defined as: asthma or reactive airways disease (RAD), decompensated congestive heart failure (CHF), and symptomatic bradycardia or heart block. Results: Frequency of use of OBB was 10.5% in GEC and 72% in GC. Frequency of use of systemic beta-blockers was 2.5% in GEC and 2% in GC. Absolute contraindications were present in 43/400 (10.8%), all of which were due to a history of asthma or RAD. A history of CHF was present in 6.25%, although all were well compensated. No patients in either group had symptomatic bradycardia or heart block. Student's t-test failed to identify a statistically significant difference in prevalence of asthma and/or RAD between the two clinic populations (p=0.1470). Difference in prevalence of compensated CHF was statistically significant between the two populations (p=0.0019). Conclusion: Frequency of absolute contraindications to beta-blockers was 43/400 (10.8%), and all due to asthma or RAD. Although our frequency of asthma was nearly two-fold that found in the literature, this increase might reflect differences in demographics. Our patients were predominantly urban African-Americans and of lower socioeconomic status as compared to the general population. Although there were 25/400 (6.25%) patients with CHF, all were in a well-compensated state and could thus safely use beta-blockers. While the list of reported potential contraindications to beta-blockers is extensive, these data suggest that the frequency of absolute contraindications is low.
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