Back to Search Start Over

Suboptimal Dosing of β-Blockers in Chronic Heart Failure: A Missed Opportunity?

Authors :
McGinlay, Melanie
Straw, Sam
Byrom-Goulthorp, Rowenna
Relton, Samuel D.
Gierula, John
Cubbon, Richard M.
Kearney, Mark T.
Witte, Klaus K.
Source :
Journal of Cardiovascular Nursing; Nov/Dec2022, Vol. 37 Issue 6, p589-594, 6p
Publication Year :
2022

Abstract

Background: The evidence base for the benefits of β-blockers in heart failure with reduced ejection fraction (HFrEF) suggests that higher doses are associated with better outcomes. Objectives: The aim of this study was to report the proportion of patients receiving optimized doses of β-blockers, outcomes, and factors associated with suboptimal dosing. Methods: This was a prospective cohort study of 390 patients with HFrEF undergoing clinical and echocardiography assessment at baseline and at 1 year. Results: Two hundred thirty-seven patients (61%) were receiving optimized doses (≥5-mg/d bisoprolol equivalent), 72 (18%) could not be up-titrated (because of heart rate < 60 beats/min or systolic blood pressure <100 mm Hg), and the remaining 81 (21%) should have been. Survival was similarly reduced in those who could not and should have been receiving 5 mg/d or greater, and patient factors did not explain the failure to attain optimized dosing. Conclusions: Many patients with HFrEF are not receiving optimal dosing of β-blockers, and in around half, there was no clear contraindication in terms of heart rate or blood pressure. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
08894655
Volume :
37
Issue :
6
Database :
Supplemental Index
Journal :
Journal of Cardiovascular Nursing
Publication Type :
Academic Journal
Accession number :
159595482
Full Text :
https://doi.org/10.1097/JCN.0000000000000847