Contemporary Use and Implications of Beta-Blockers in Patients With HFmrEF or HFpEF

• DOI: 10.1016/j.jchf.2023.09.007
• Publication Date: 2023-09-27T09:07:05Z
• Authors: Alexander Peikert; Bradley A. Bart; Muthiah Vaduganathan; Brian L. Claggett; Ian J. Kulac; Mikhail N. Kosiborod; Akshay S. Desai; Pardeep S. Jhund; Carolyn S.P. Lam; Silvio E. Inzucchi; Felipe A. Martinez; Rudolf A. de Boer; Adrian F. Hernandez; Sanjiv J. Shah; Magnus Petersson; Anna Maria Langkilde; John J.V. McMurray; Scott D. Solomon; Orly Vardeny
• Keywords: Beta blocker; BETA (programming language)

While beta-blockers are not recommended for the treatment of HFpEF according to latest ESC and AHA/ACC/HFSA guidelines, these therapies remain commonly used comorbidity management. There has been concern that might adversely influence clinical outcomes by limiting chronotropic response in HFpEF. To examine contemporary use implications patients with HFmrEF or In DELIVER trial, a total 6,263 symptomatic HF LVEF >40% were randomized dapagliflozin placebo across 20 countries. this prespecified analysis, efficacy safety examined beta-blocker at randomization. The primary outcome was cardiovascular death worsening HF. Overall, 5,177 (83%) wide variation geographic region. Beta-blocker associated lower risk covariate-adjusted models (HR 0.70 [95% CI 0.60-0.83]). Dapagliflozin consistently reduced taking 0.82 0.72-0.94]) those 0.79 0.61-1.03]; Pinteraction=0.85), similar findings key secondary endpoints. Adverse events balanced between placebo, regardless background use. enrolled DELIVER, 4 out 5 participants treated beta-blocker. higher death. safely events, irrespective