P-Blockers and retroperitoneal fibrosis

It has been suggested that {3-blockers cause retroperitoneal fibrosis. However , idiopathic retroperitoneal fibrosis may cause hypertension and in 7 cases of (3 -blocker-induced retroperitoneal fibrosis (reported in the literature since 1978) it was not stated whether the hypertension and the use of 13-blockers preceded the development of the retroperitoneal fibrosis or vice-versa. If the retroperitoneal fibrosis was diagnosed after the hypertension was treated with {3-blockers, the drug could be associated with the former disease. However, ' ___ although {3-blockers have been implicated as a cause of retroperitoneal fibrosis. the evidence reported to date is circumstantial at best and fails to document a cause and effect relationship ' _ The reported cases also failed to demonstrate a temporal relationship between drug and effect and , further , it has been suggested that because (3-blockers are prescribed so frequently it is not unlikely that a patient taking a (3-blocker will have retroperitoneal fibrosis . The results of a retrospective study showed that , while 6 patients were taking (3-blockers before retroperitoneal fibrosis developed, the disease developed in 24 patients before they began therapy with (3-blockers and therapy continued after the retroperitoneal fibrosis was cured did not produce a recurrence of the disease, Thus, it appears that 'retroperitoneal fibrosis is either an incidental finding in patients taking (3-blockers. or hypertenSion occurs secondary to the urinary tract obstruction caused by retroperitoneal fibrosis and /3-blockers are used to treat the hypertension'. Proulx, S. and Schneweiss, F .. Drug InteliJgence and Clinical Pharmacy 19. 359-360 (May 1985)