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[Frequency of use and Indications for Beta-Blockers in Heart Failure with Preserved Ejection Fraction]

E V Kokhan1, G K Kiyakbaev1, Zh D Kobalava1

  • 1Peoples' Friendship University of Russia (RUDN University), Russia, Moscow.

Kardiologiia
|July 29, 2020
PubMed

Insights

Beta-blocker prescriptions for chronic heart failure with preserved ejection fraction (CHF-PEF) significantly increased from 1993-2019. However, the prevalence of conditions like arterial hypertension and atrial fibrillation, which often indicate beta-blocker use, did not significantly change.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Research

Background:

  • Chronic heart failure with preserved ejection fraction (CHF-PEF) is a growing clinical concern.
  • Beta-blockers are commonly prescribed for cardiovascular conditions, but their use in CHF-PEF requires careful evaluation.
  • Understanding prescribing trends and indications is crucial for optimizing patient care.

Purpose of the Study:

  • To analyze trends in beta-blocker prescribing for patients with CHF-PEF.
  • To examine the incidence of key indications for beta-blocker use, including arterial hypertension (AH), atrial fibrillation (AF), ischemic heart disease (IHD), and myocardial infarction (MI).
  • To assess changes in these trends over time within clinical studies.

Main Methods:

  • A systematic literature search was conducted in PubMed and EMBASE databases.
  • Included randomized controlled studies (RCSs) of pharmacological therapies for CHF-PEF patients from 1993 to 2019.
  • Analyzed baseline characteristics, beta-blocker prescribing rates, and prevalence of AH, AF, IHD, and MI using the Mann-Kendall test.

Main Results:

  • Beta-blocker prescribing significantly increased from 1993 to 2019, reaching 80% in recent studies (tau=0.51; p=0.014).
  • The prevalence of IHD, MI, AH, and AF did not significantly change among study participants (p>0.05).
  • A trend towards increasing prevalence was observed for AH and AF, becoming statistically significant for AF after excluding one study (tau=0.5; p=0.042).

Conclusions:

  • Beta-blocker prescribing in clinical studies for CHF-PEF has significantly increased over the past two decades.
  • The incidence of common indications for beta-blocker administration (AF, AH, MI, IHD) remained largely unchanged during this period.
  • This suggests a potential shift in prescribing patterns or broader use of beta-blockers in CHF-PEF, irrespective of specific guideline indications.

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