Beta blockers
The 2024 AHA/ACC guideline recommends continuing established beta-blocker therapy through the perioperative period, with adjustments according to clinical circumstances.
The guideline advises against starting a beta blocker on the day of surgery when there is no immediate indication. When a new indication exists, it recommends initiation sufficiently in advance to assess tolerability and titrate the dose, preferably more than 7 days before surgery.