Health notes: Docs use stress tests, beta blockers before non-cardiac surgery too often, U-M study finds

Physicians could order far fewer stress tests and beta blockers before non-cardiac surgeries, cutting unnecessary costs and procedures without causing complications to their patients, a recent U-M report concluded.

In the report released online ahead of print in Annals of Internal Medicine, U-M researchers said patients with stable heart disease could avoid certain testing and procedures. These tests can be costly, lead to more invasive and potentially unnecessary testing and may trigger as many events as it prevents.

This week, the American College of Cardiology and the American Heart Association released new guidelines showing pre-operative medications should be reserved only for high-risk patients undergoing complicated surgeries.

“Physicians may struggle with implementing these evidence-based guidelines for a variety of reasons, including legal concerns regarding pre-operative cardiac events, pressure from surgical colleagues and reliance on testing and procedures for income,” says senior author Kim Eagle, director of the U-M Cardiovascular Center in a release.

“It’s imperative that any form of health care reform provide incentives to follow these guidelines,” Eagle says. “It is the quality of care, not the quantity of tests, that matters most.”

U-M Health system said pre-operative clinics are adhering to the principles of the new guidelines, have improved test appropriateness and patient outcomes while reducing costs by 50 to 70 percent.

U-M researchers find gene variant that puts some at greater risk of heart failure
Patients who have high blood pressure and have a certain gene variant that impacts the way their body processes vitamin D are twice as likely to have congestive heart failure, a U-M researcher found.

Previous studies have found links between heart disease and vitamin D deficiencies.

“This study is the first indication of a genetic link between vitamin D action and heart disease,” Robert U. Simpson, professor of pharmacology at the University of Michigan Medical School said in a release. Simpson co-authored the study in the journal Pharmacogenomics with researchers from the Medical Colleges of Wisconsin and the Marshfield Clinic Research Foundation.

Tina Reed covers health and the environment for AnnArbor.com. You can reach her at tinareed@annarbor.com, call her at 734-623-2535 or find her on Twitter @TreedinAA.