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[Use of betablockers in elderly patients with congestive heart failure]
Agustín Urrutia1, Josep Lupón, Salvador Altimir
1Unidad de Insuficiencia Cardíaca, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain. aurrutia@ns.hugtip.scs.es
Insights
Beta-blockers (BB) in elderly patients with congestive heart failure (CHF) showed good tolerance and significantly reduced one- and two-year mortality. Patients on BB had better functional status and fewer comorbidities like COPD.
Area of Science:
- Cardiology
- Geriatrics
- Pharmacology
Background:
- Limited research exists on beta-blocker (BB) use in elderly patients with congestive heart failure (CHF).
- Understanding BB characteristics and outcomes in this demographic is crucial for treatment optimization.
Purpose of the Study:
- To evaluate the characteristics of elderly CHF patients treated with BB.
- To assess the association between BB use and patient outcomes, specifically mortality.
Main Methods:
- A cohort of patients aged 75 years and older with CHF was evaluated.
- Clinical and functional characteristics, including mortality, were compared between patients treated with and without BB.
Main Results:
- 47% of elderly CHF patients received BB with good tolerance; only 3 required withdrawal.
- Patients on BB were younger, had less severe CHF (NYHA class), and fewer comorbidities (e.g., COPD).
- One-year mortality was 5.7% in the BB group versus 27.6% in the no-BB group (p=0.01); two-year mortality was 20.68% versus 60% (p=0.002).
Conclusions:
- Beta-blockers are well-tolerated and beneficial in elderly patients with CHF.
- BB treatment is associated with improved functional status and significantly lower short- and medium-term mortality in this population.
Background And Objective:
Few studies of betablockers (BB) have been performed specifically in older patients with congestive heart failure (CHF). We evaluated the characteristics of elderly patients with CHF treated with BB. Moreover, we assessed whether BB are associated with a better outcome in them.
Patients And Method:
We evaluated clinical and functional characteristics of patients aged > or = 75 years with CHF treated with or without BB, with special interest being paid in the mortality.
Results:
47 out of 107 patients were treated with BB. Only in 3 it was necessary to withdraw BB. Patients treated with no BB were older, with a higher New York Heart Association (NYHA) class, more prevalent chronic obstructive pulmonary disease (COPD) and in poorer functional situation. In patients treated with BB, ischemic heart disease was more prevalent. Reasons for "no treatment with BB" were severe aortic stenosis (n = 2), severe mitral regurgitation (n = 9), asthma-COPD (n = 28), arterial disease (n = 16) and fragility (n = 9). 25% of the patients on BB reached the target dose. One-year mortality (5.7% vs 27.6%) and 2-year mortality (20.68% vs 60%) were both significantly lower (p = 0.01 and p = 0.002, respectively) in patients on BB.
Conclusions:
44% of our elderly patients with CHF received BB with good tolerance. Patients treated with BB were younger, with more ischemic heart disease, better NYHA class, less functional deterioration and without COPD. One-year and two-year mortality in patients who can receive BB were lower.
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