02860nas a2200361 4500008004100000022001400041245013800055210006900193260001300262300001100275490000800286520181600294653003202110653001602142653000902158653002202167653001102189653002202200653001802222653001102240653000902251100002102260700001902281700002302300700002102323700002302344700001902367700001802386700002102404700001802425700002002443856003502463 2005 eng d a1097-674400aAssociation of beta-blocker use with mortality among patients with congestive heart failure in the Cardiovascular Health Study (CHS).0 aAssociation of betablocker use with mortality among patients wit c2005 Sep a464-700 v1503 a

BACKGROUND: In clinical trials, beta-blocker therapy reduces all-cause mortality among people with congestive heart failure (CHF) characterized by depressed systolic function, but few trials included large numbers of elderly participants. This study assessed the association between beta-blocker therapy and mortality among community-dwelling older adults with CHF.

METHODS: The Cardiovascular Health Study (CHS) is a longitudinal, population-based study of adults aged > or = 65 years. Recruitment began in 1989 with follow-up extending through June 2000 or death. Cox proportional hazard regression models were used to assess the association between beta-blocker therapy and all-cause mortality among 950 participants who developed new-onset CHF.

RESULTS: beta-Blocker users (n = 157) were more likely than nonusers (n = 793) to have treated hypertension, clinical coronary artery disease, and valvular disease at the time of CHF diagnosis. Death occurred in 67 users and 446 nonusers during a median follow-up of 2.3 years. Compared with nonuse, use of beta-blockers was associated with a multivariable adjusted hazard ratio (HR) of 0.74 (95% CI 0.56-0.98) for all-cause mortality. Among the 520 participants who had left ventricular ejection fraction assessed within 90 days after CHF diagnosis, the risk for all cause mortality associated with beta-blocker use did not differ significantly between those with ejection fraction of < 40% and those with ejection fraction of > or = 40% (HR 0.56, 95% CI 0.27-1.13; HR 0.82, 95% CI 0.56-1.22, respectively; interaction P = .34).

CONCLUSIONS: This observational study suggests that beta-blocker treatment is associated with a reduced risk of all-cause mortality among community-dwelling older adults with CHF.

10aAdrenergic beta-Antagonists10aAge Factors10aAged10aAged, 80 and over10aFemale10aFollow-Up Studies10aHeart Failure10aHumans10aMale1 aChan, Jeannie, D1 aRea, Thomas, D1 aSmith, Nicholas, L1 aSiscovick, David1 aHeckbert, Susan, R1 aLumley, Thomas1 aChaves, Paulo1 aFurberg, Curt, D1 aKuller, Lewis1 aPsaty, Bruce, M uhttps://chs-nhlbi.org/node/856