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Tolerability of beta-blockers in elderly patients with chronic heart failure: the COLA II study

Henry Krum1, Julie Hill, Friedrich Fruhwald

  • 1NHMRC Centre for Clinical Research Excellence in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, 3rd Floor, Burnet Tower, AMREP Precinct, Commercial Road, Melbourne Vic 3004, Australia. henry.krum@med.monash.edu.au

European Journal of Heart Failure
|October 4, 2005
PubMed

Insights

Beta-blockers like carvedilol are well-tolerated in elderly patients with chronic heart failure (CHF). This study shows 80% tolerability, suggesting older adults with CHF should not be denied carvedilol treatment.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Pharmacology

Background:

  • Beta-blockers are guideline-recommended for chronic heart failure (CHF).
  • Tolerability concerns limit beta-blocker use in elderly CHF patients.
  • Carvedilol is a key beta-blocker for heart failure management.

Purpose of the Study:

  • To evaluate the tolerability of carvedilol in elderly patients (>70 years) with CHF.
  • To assess carvedilol's real-world effectiveness in a large, multinational cohort.
  • To identify predictors of carvedilol tolerability in older adults.

Main Methods:

  • Prospective, multinational evaluation of 1030 CHF patients aged >70 years.
  • Patients received carvedilol in everyday clinical practice.
  • Tolerability defined as adherence to carvedilol therapy for ≥3 months, with a dose of ≥6.25 mg twice daily at 6 months.

Main Results:

  • Overall carvedilol tolerability was 80% in elderly CHF patients.
  • Tolerability rates were 84.3% (70-75 years), 76.8% (76-80 years), and 76.8% (>80 years).
  • Advanced age, low diastolic blood pressure, reduced left ventricular ejection fraction (LVEF), obstructive airways disease, and diabetes predicted lower tolerability.

Conclusions:

  • Carvedilol is well-tolerated in this cohort of elderly patients with chronic heart failure.
  • Concerns about tolerability should not prevent the use of carvedilol in elderly CHF patients.
  • Real-world data support carvedilol's use in older populations with heart failure.
Abstract

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