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Review: β blockers reduce mortality and therapy withdrawal in heart failure but increase dizziness and bradycardia

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 Q In patients with heart failure (HF) with systolic dysfunction, what are the risks associated with β blocker therapy?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★★☆ Internal medicine ★★★★★★☆ Cardiology ★★★★★☆☆


Embedded ImageData sources:

studies were identified by searching Medline (1966–2002) and bibliographies of relevant articles.

Embedded ImageStudy selection and assessment:

studies were selected if they were randomised controlled trials (RCTs) that used non-crossover designs, compared β blocker therapy with placebo in patients with HF with left ventricular systolic dysfunction, enrolled ⩾100 patients in each treatment group, had ⩾6 months of follow up, and reported adverse effects.

Embedded ImageOutcomes:

all cause therapy withdrawal, all cause mortality, HF hospital admission, worsening HF, hypotension, dizziness, bradycardia, and fatigue.


9 RCTs (14 594 patients, …

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  • For correspondence: Dr H M Krumholz, Yale University, New Haven, CT, USA.

  • Source of funding: no external funding.

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