Prospective surgical patients concerned about the data in this study ought to talk with their doctors to put the information into perspective, says Thomas Vail, MD, president of the American Association of Hip and Knee Surgeons in Rosemont, Ill.

“This study is very useful from the standpoint of raising awareness,” Dr. Vail says. “As it relates to an individual patient, what one has to do is take this background information provided in a large population and ask yourself, ‘Well, how might this apply to my circumstances? For example, do I have specific cardiac risk factors?’”

Arthur Wallace, MD, an attending anesthesiologist at the San Francisco VA Medical Center wrote an accompanying commentary to the study. He says steps must be taken beyond just recognizing risk. “Just knowing your risk is high doesn’t help,” he says. “What are you going to do, just worry more? You need to reduce the risk.”

At the hospital where Dr. Wallace works – and at many others – risk reduction for joint replacement surgery can include the use of cardiac medications, such as beta blockers and statins, during the perioperative period. Patients who already take them continue doing so, and patients with a combination of known but untreated risk factors – such as hypertension, elevated cholesterol and/or diabetes – are started on them before the surgery.

"There is good evidence that this is not only safe, but also best practice," says Dr. Vail.

About 40,000 surgical patients at the San Francisco VA Medical Center have followed this protocol since 1998, reducing their overall risk of cardiac complications by about 35 percent, Dr. Wallace says. “That’s pretty good.”