Beta Blockers More Effective than Lower Heart Rate in Ambulatory Heart Failure Patients

As new drugs for lowering heart rate become available, physicians treat heart failure patients may chose these agents instead of increasing doses of beta blockers. A multi-center study finds that could be the wrong choice.

Upping dosages of beta-blockers appears more effective than lowering heart rate in treating heart failure patients. That finding is particularly important as new products for lowering heart rate become available, a new study found.

Heart rate is an important modifiable factor in reducing deaths in heart failure patients. Titrating doses of beta blockers (BBs) also improves outcomes in chronic heart failure patients with reduced ejection fraction.

Writing in the Journal of the American College of Cardiology: Heart Failure, Mona Fiuzat, PharmD, of the Duke Clinical Research Institute in Durham, NC and colleagues at other institutes compared which treatment showed the stronger effect. Their study is called HF-ACTION.

The team found there was a “significant inverse relationship between either treatment and all-cause death and hospitalization.”

But when they adjusted for other predictors of outcome “only BB does remained significant for improving outcomes of all-cause death or hospitalization”

As for improved outcomes on other cardiovascular endpoints, changing BB does “did not remain significant when adjusted for other predictors of outcome in this cohort.”

The study involved 2,331 patients. Among the study limitations: it did not include patients who were not ambulatory and sicker patients may not be able to tolerate higher doses of beta blockers.

The authors note that on the positive side, the study included “a relatively large cohort of women and of black patients.”