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The effectiveness and tolerance of betablockers in elderly patients (> or = 70 years) with heart failure

R Cristodorescu1, D Darabantiu, Ruxandra M Christodorescu

  • 1Cardiology Department, City Hospital, Timişoara, Romania.

Romanian Journal of Internal Medicine = Revue Roumaine De Medecine Interne
|November 9, 2004
PubMed

Insights

Beta blockers (BB) are well-tolerated and effective for elderly patients with heart failure (HF). This study found similar outcomes in older and younger adults, suggesting BBs should be considered for all HF patients.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Beta blockers (BB) are underprescribed in elderly patients with heart failure (HF).
  • Limited data exists on BB effectiveness and tolerance in older adults with HF due to LV systolic dysfunction.

Purpose of the Study:

  • To assess the effectiveness and tolerance of BBs (metoprolol, bisoprolol, carvedilol) in elderly (>=70 years) versus younger (<70 years) patients with HF.
  • To compare outcomes including symptomatic improvement, readmission rates, and mortality.

Main Methods:

  • A comparative study of 57 elderly patients (group 1) and 101 younger patients (group 2) with HF.
  • Patients received BBs on top of conventional therapy.
  • Outcomes assessed included NYHA class, BB withdrawal due to intolerance, HF readmissions, and 1-year mortality.

Main Results:

  • No significant differences in baseline characteristics between groups.
  • Lower BB doses were used in the elderly group, significantly only for bisoprolol.
  • Intolerance leading to BB withdrawal was similar (12% vs. 10%, p>0.05).
  • Both groups showed symptomatic improvement (decreased NYHA class).
  • Readmission for worsening HF (42% vs. 39%) and 1-year mortality (11.4% vs. 10.4%) were similar between groups.

Conclusions:

  • Beta blockers are generally tolerated and effective in elderly patients with heart failure.
  • Age should not be a barrier to prescribing BBs in HF patients without contraindications.
  • BBs should be considered for all patients with HF, irrespective of age, if no contraindications exist.
Abstract

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