Association of β-blocker use with mortality among patients with congestive heart failure in the Cardiovascular Health Study (CHS)

Jeannie D. Chan, Thomas D. Rea, Nicholas L. Smith, David Siscovick, Susan R. Heckbert, Thomas Lumley, Paulo Chaves, Curt D. Furberg, Lewis Kuller, Bruce M. Psaty

Research output: Contribution to journalArticle

Abstract

Background: In clinical trials, β-blocker therapy reduces all-cause mortality among people with congestive heart failure (CHF) characterized by depressed systolic function, but few trials included large numbers of elderly participants. This study assessed the association between β-blocker therapy and mortality among community-dwelling older adults with CHF. Methods: The Cardiovascular Health Study (CHS) is a longitudinal, population-based study of adults aged ≥65 years. Recruitment began in 1989 with follow-up extending through June 2000 or death. Cox proportional hazard regression models were used to assess the association between β-blocker therapy and all-cause mortality among 950 participants who developed new-onset CHF. Results: β-Blocker users (n = 157) were more likely than nonusers (n = 793) to have treated hypertension, clinical coronary artery disease, and valvular disease at the time of CHF diagnosis. Death occurred in 67 users and 446 nonusers during a median follow-up of 2.3 years. Compared with nonuse, use of β-blockers was associated with a multivariable adjusted hazard ratio (HR) of 0.74 (95% CI 0.56-0.98) for all-cause mortality. Among the 520 participants who had left ventricular ejection fraction assessed within 90 days after CHF diagnosis, the risk for all cause mortality associated with β-blocker use did not differ significantly between those with ejection fraction of <40% and those with ejection fraction of ≥40% (HR 0.56, 95% CI 0.27-1.13; HR 0.82, 95% CI 0.56-1.22, respectively; interaction P = .34). Conclusions: This observational study suggests that β-blocker treatment is associated with a reduced risk of all-cause mortality among community-dwelling older adults with CHF.

Original languageEnglish (US)
Pages (from-to)464-470
Number of pages7
JournalAmerican heart journal
Volume150
Issue number3
DOIs
StatePublished - Sep 2005

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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