Authors:

Dylan K. Stone

Date Created:

Not specified

Course Title:

Professor:

Not specified

About Paper:

Beta-blocker (BB) therapy improves survival in heart failure with reduced ejection fraction, but its role in heart failure with preserved ejection fraction (HFpEF) is uncertain. Recent post-myocardial infarction trials have further questioned routine, long-term beta blockade. We analyzed 620 adults in the Cardiometabolic Center Alliance registry (March 2019 - May 2025) with HFpEF and two or more visits across 11 sites. BB exposure was categorized as none, low, moderate, or high per guideline dose equivalents. Among 620 patients, 72.8% were on BBs at index: 3.3% low-, 80.0% moderate-, and 16.7% high-dose therapy. Dose intensity was not aligned with recent ischemic events: 83.2% of patients whose coronary events occurred over 12 months prior remained on moderate-high doses. Guideline-directed HF disease-modifying therapies were underused and less frequent without BBs (ARNI 11.3% vs 6.5%; SGLT2 inhibitor 60.4% vs 58.9%). Unadjusted one-year HF hospitalization (22.4% vs 23.0%) and syncope (3.8% vs 3.6%) were similar for BB-treated vs untreated patients. In this multisite HFpEF cohort, nearly 75% of patients received BB therapy, most at moderate or high doses, despite limited HFpEF-specific benefit and few hemodynamic indications. These patterns reflect a lack of tailored prescribing and highlight opportunities to de-escalate or discontinue therapy in selected patients while emphasizing lifestyle and alternative treatments. OOP OM OHOOHSOHOOOHOHOSHOCSCOSOHC OOK SOCCOHOSOOHOSGOGCOSOOOOCEOO GIDDIDFIIDHDSDIDAD SD SDIDHSDDBDOHOODDIHDDHDDHODOVDISSO

Source:

Northwestern University

Topics:

No topics listed

Co-authors:

Dylan K. Stone