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Discontinuation of beta-blockers in cardiovascular disease: UK primary care cohort study

Paul R Kalra1, Chris Morley, Susie Barnes

  • 1Department of Cardiology, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom. paul.kalra@porthosp.nhs.uk

International Journal of Cardiology
|July 31, 2012
PubMed

Insights

A quarter of patients discontinue beta-blockers within one year, rising to 50% by three years for cardiovascular conditions. This highlights urgent needs to address beta-blocker prescribing difficulties in at-risk patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Primary Care Medicine

Background:

  • Beta-blockers are crucial for managing cardiovascular diseases like chronic heart failure (CHF), myocardial infarction (MI), and angina.
  • Understanding long-term beta-blocker usage patterns is essential for optimizing patient outcomes.

Purpose of the Study:

  • To investigate beta-blocker usage patterns in a national UK primary care cohort.
  • To analyze discontinuation rates, initiation dosages, titration, and adverse events associated with beta-blocker therapy.

Main Methods:

  • Retrospective cohort study using the UK General Practice Research Database (2004-2008).
  • Inclusion of patients with a first diagnosis of CHF, MI, or angina and first-ever beta-blocker prescription.
  • Outcome measures included beta-blocker discontinuation, initiation dosages, titration, and adverse events.

Main Results:

  • 27% of patients discontinued beta-blockers within 1 year, increasing to 50% by 3 years.
  • Initiation dosages averaged 33% of guideline-recommended targets, rising to 40% in persistent users.
  • Common adverse events included dyspnoea, fatigue, and dizziness.

Conclusions:

  • High rates of beta-blocker discontinuation are observed across major cardiovascular conditions.
  • There is a significant need to address prescribing challenges to improve long-term beta-blocker adherence.
  • Optimizing beta-blocker therapy is critical for patients with CHF, MI, and angina.
Abstract

Keywords:
AnginaBeta-blockersHeart failureMyocardial infarctionPersistence

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