Beta-blockers in vascular surgery patients: is the debate still going on?

Patients undergoing vascular surgery are under increased risk for perioperative myocardial ischemia and cardiovascular complications, and optimal medical treatment is therefore imperative for these patients. Beta-blockade has been introduced as a cornerstone of optimal management, and standardized preoperative initiation has been recommended in the past. However, recent pooled data have questioned prior recommendations and have led to revision of international guidelines. This review aims to highlight the debate on perioperative beta-blockade for vascular surgery patients in order to produce useful conclusions for everyday clinical practice.