Beta blockers significantly reduced mortality compared to controls in patients with heart failure (8.0% vs 12.8%; OR 0.63; 95% CI 0.55-0.72; P<0.00001).
Systematic Review (n=10,480)
Do beta blockers reduce mortality and hospital admissions in patients with heart failure?
Beta blockers reduce the risk of mortality and heart failure hospital admissions by approximately one third in patients with predominantly non-severe heart failure.
Effect estimate: OR 0.63 (95% CI 0.55-0.72)
Absolute Event Rate: 8% vs 12.8%
p-value: p=<0.00001
Heart failure is a common condition that carries a high burden of mortality and morbidity. Several randomised trials have evaluated the effects of beta blockers in heart failure. This paper gives a systematic overview of published randomised trials of beta blockers in heart failure using standard methods. In all, 22 randomised controlled trials were identified with a total of 10480 patients, and an average of 11 months of treatment. The average age was 61 years and 4% were female. Most studies excluded patients with severe heart failure. Death rates in patients randomised to receive beta blockers compared to controls were 458/5657 (8.0%) and 635/4951 (12.8%) respectively, odds ratio 0.63, 95% CI 0.55-0.72, P<0.00001. Similar reductions were observed for hospital admissions for worsening heart failure (11.3 vs. 17.1%, respectively, odds ratio 0.63) and for the composite outcome of death or heart-failure hospital admission (19.4 vs. 26.9%, respectively, odds ratio 0.66). These results show that beta blockers reduce the risk of mortality or the need for heart-failure hospital admission by approximately one third. Absolute reductions of 5-6% in event rates were observed over approximately 1 year of treatment period. These important benefits should be implemented as a priority, since treatment with beta blockers is inexpensive and heart failure carries a high risk of death and disability. Further information on the effect of beta blockers in elderly patients and women would be helpful.
Shibata et al. (Fri,) conducted a systematic review in Heart failure (n=10,480). Beta blockers vs. Controls was evaluated on Death (OR 0.63, 95% CI 0.55-0.72, p=<0.00001). Beta blockers significantly reduced mortality compared to controls in patients with heart failure (8.0% vs 12.8%; OR 0.63; 95% CI 0.55-0.72; P<0.00001).
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