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Association of beta-blocker use with mortality among patients with congestive heart failure in the Cardiovascular Health Study (CHS).
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | Association of beta-blocker use with mortality among patients with congestive heart failure in the Cardiovascular Health Study (CHS). |
| Publication Type | Journal Article |
| Year of Publication | 2005 |
| Authors | Chan, JD, Rea, TD, Smith, NL, Siscovick, D, Heckbert, SR, Lumley, T, Chaves, P, Furberg, CD, Kuller, L, Psaty, BM |
| Journal | Am Heart J |
| Volume | 150 |
| Issue | 3 |
| Pagination | 464-70 |
| Date Published | 2005 Sep |
| ISSN | 1097-6744 |
| Keywords | Adrenergic beta-Antagonists, Age Factors, Aged, Aged, 80 and over, Female, Follow-Up Studies, Heart Failure, Humans, Male |
| Abstract | <p><b>BACKGROUND: </b>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.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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).</p><p><b>CONCLUSIONS: </b>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.</p> |
| DOI | 10.1016/j.ahj.2004.12.022 |
| Alternate Journal | Am Heart J |
| PubMed ID | 16169325 |
| Grant List | N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01-HL-15103 / HL / NHLBI NIH HHS / United States N01-HL-35129 / HL / NHLBI NIH HHS / United States R01-AG-09556 / AG / NIA NIH HHS / United States |