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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 ★★★★★☆☆
METHODS
Data sources:
studies were identified by searching Medline (1966–2002) and bibliographies of relevant articles.
Study 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.
Outcomes:
all cause therapy withdrawal, all cause mortality, HF hospital admission, worsening HF, hypotension, dizziness, bradycardia, and fatigue.
MAIN RESULTS
9 RCTs (14 594 patients, …
Footnotes
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For correspondence: Dr H M Krumholz, Yale University, New Haven, CT, USA. Harlan.krumholzyale.edu
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Source of funding: no external funding.
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