Beta blockers offer benefits in symptom management, cardiac function, and overall outcomes for older patients with HFrEF, based on a scoping review of 12 studies encompassing 26,426 patients.
Do beta-blockers improve outcomes and tolerability in older patients with heart failure?
This scoping review confirms that beta-blockers are beneficial and viable for older patients with HFrEF, highlighting the need for careful dose titration and monitoring.
Beta blockers (BBs) play a crucial role in enhancing the quality of life and extending the survival of patients with heart failure and reduced ejection fraction (HFrEF). Initiating the therapy at low doses and gradually titrating the dose upwards is recommended to ensure therapeutic efficacy while mitigating potential adverse effects. Vigilant monitoring for signs of drug intolerance is necessary, with dose adjustments as required. The management of older HF patients requires a case-centered approach, taking into account individual comorbidities, functional status, and frailty. Older adults, however, are often underrepresented in randomized clinical trials, leading to some uncertainty in management strategies as patients with HF in clinical practice are older than those enrolled in trials. The present article performs a scoping review of the past 25 years of published literature on BBs in older HF patients, focusing on age, outcomes, and tolerability. Twelve studies (eight randomized-controlled and four observational) encompassing 26,426 patients were reviewed. The results indicate that BBs represent a viable treatment for older HFrEF patients, offering benefits in symptom management, cardiac function, and overall outcomes. Their role in HF with preserved EF, however, remains uncertain. Further research is warranted to refine treatment strategies and address specific aspects in older adults, including proper dosing, therapeutic adherence, and tolerability.
Parrini et al. (Fri,) conducted a review in Heart failure in older adults (n=26,426). Beta blockers was evaluated on Symptom management, cardiac function, and overall outcomes. Beta blockers offer benefits in symptom management, cardiac function, and overall outcomes for older patients with HFrEF, based on a scoping review of 12 studies encompassing 26,426 patients.