I am an orthopedic surgeon in the Northeast. Our hospital's anesthesia providers have endorsed the national recommendations that most patients over 60 should be on a beta blocker med prior to elective general anesthesia. Now that recommendations seem to point to combos of ACE inhibitors and Ca channel blockers what is going to become of the beta blocker recommendation? This would require changing the patient's meds preop, continuing them postop for 30 days and switching back. As I understand it, the combo above does NOT reduce the anesthesia risk like beta blockers do. The government is monitoring the level of compliance with the beta blockers as an indicator of "quality care". Thoughts?