Effects of Bisoprolol Treatment for Chronic Heart Failure Initiated and Followed up by Primary Care Physicians

UNLABELLED: Primary care physicians prescribe beta-blockers for chronic heart failure infrequently. The aims of the study were to assess the effects of beta-blocker treatment in out-clinic patients with regard to NYHA class and frequency of adverse events. Beta-blocker treatment was initiated and followed up by primary care physicians. METHODS: Chronic heart failure patients already treated with ACE-inhibitors and diuretics were included. The 24-week follow-up consisted of a titration phase followed by a maintenance phase. The patients received the beta-blocker bisoprolol with an initial dose of 1.25 mg and a maximal dose of 10 mg. RESULTS: NYHA class II, III and IV had 174, 146, and one patient, respectively. Treatment duration lasted 189+/-73 days with a maximal bisoprolol dose of 7.2+/-3.2 mg. Sixty-one percent of the patients tolerated at least 7.5 mg bisoprolol. The NYHA class improved from 2.4+/-0.5 at baseline to 1.8+/-0.6 at week 24 (P<0.001). At final assessment, 74% of the patients showed an improvement. The number of permanent treatment withdrawals was 57 (17%). Death occurred in six patients and hospitalisation in 38 patients. CONCLUSIONS: Bisoprolol treatment in patients with chronic heart failure was effectively and safely carried out by primary care physicians.