Suboptimal Dosing of ß-Blockers in Chronic Heart Failure: A Missed Opportunity?
J Cardiovasc Nurs
; 37(6): 589-594, 2022.
Article
em En
| MEDLINE
| ID: mdl-34321430
ABSTRACT
BACKGROUND:
The evidence base for the benefits of ß-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 ß-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 ß-blockers, and in around half, there was no clear contraindication in terms of heart rate or blood pressure.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Insuficiência Cardíaca
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article