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Beta-blocker therapy in elderly patients with renal dysfunction and heart failure
Juan Martínez-Milla1,2, Marcelino Cortés García1, Julia Anna Palfy3
1Department of Cardiology, Hospital Universitario Fundación Jiménez Díaz-Quirónsalud.
Journal of Geriatric Cardiology : JGC
|February 22, 2021
Summary
Beta-blockers (BB) significantly reduce mortality in elderly patients with chronic kidney disease (CKD) and heart failure with reduced ejection fraction. These findings support the use of BB in this vulnerable population.
Area of Science:
- Cardiology
- Nephrology
- Geriatrics
Background:
- Elderly patients with chronic kidney disease (CKD) often have heart failure with reduced ejection fraction (HFrEF).
- The role of beta-blockers (BB) in managing HFrEF in CKD patients is not fully understood.
Purpose of the Study:
- To evaluate the effectiveness of beta-blockers (BB) in reducing mortality and cardiovascular events in patients aged 75 years and older with CKD and HFrEF.
Main Methods:
- A cohort of 390 patients (age ≥ 75) with HFrEF (ejection fraction ≤ 35%) and varying stages of CKD (GFR ≤ 60 mL/min/1.73 m²) were analyzed.
- The study examined the association between BB use and outcomes, including mortality and major cardiovascular events, over a median follow-up of 28 months.
Main Results:
- 67.4% of patients received BB. BB use was associated with a significant reduction in mortality (HR = 0.51).
- Reduced mortality risk with BB was observed across all CKD stages: IIIa (HR = 0.47), IIIb (HR = 0.55), and IV/V (HR = 0.29).
- Major cardiovascular events occurred in 65.9% of patients.
Conclusions:
- Beta-blocker therapy is associated with a better prognosis in elderly patients with HFrEF and renal impairment.
- Encouraging the use of BB in this patient group is recommended when clinically appropriate.
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