[Beta blockers in elderly with heart failure]

Despite the importance of beta-blockers for secondary prevention after acute myocardial infarction, several studies suggested that they are substantially underutilized, particularly in elderly patients. Actually no randomized clinical trial including elderly patients with heart failure treated with beta-blockers is reported in the literature. However, previous studies showed that beta-blocker therapy was associated with a reduction in total cardiac mortality (-40%) of elderly patients with acute myocardial infarction without left ventricular dysfunction. Furthermore, a meta-analysis of five trials including 1729 patients aged > 60 years with heart failure evidenced a non-significant trend versus total mortality reduction in patients receiving beta-blockers (odds ratio 0.68, 95% confidence interval 0.51-0.93, p = 0.4).