The following is a summary of “Beta blockers are associated with lower all-cause mortality among HFpEF patients,” published in the May 2024 issue of Cardiology by Ibrahim et al.

Patients suffering from heart failure with preserved ejection fraction (HFpEF) often use beta blockers (BBs). However, the effectiveness of BBs is uncertain, and questions about BBs are raised in these patients. 

Researchers conducted a retrospective study analyzing the correlation of BB with all-cause mortality in patients with HFpEF.

They studied 20,206 patients with left ventricular ejection fraction (EF) ≥ 50%, hospitalized for decompensated HF from January 2011 to March 2020. Survival was assessed at 30 days, 1 year, and 3 years. The mortality differences in patients on BBs were also analyzed with additional indications such as hypertension [HTN], coronary artery disease [CAD], and atrial fibrillation [AF] and were compared to those on BBs with spironolactone or angiotensin-converting enSzyme inhibitors/angiotensin receptor blockers (ACEi/ARBs). 

The results showed that BB was correlated with reduced all-cause mortality at 30 days, 1 year, and 3 years (P<0.0001), confirmed by propensity score matching. Adding BB to spironolactone or ACEi/ARBs significantly reduced mortality at 3 years (P=0.0359 with spironolactone; P<0.0001 with ACEi/ARBs). 

Investigators concluded that BBs were linked to lower mortality in patients with HFpEF recent decompensated HF hospitalization. The benefit extended to those on spironolactone or ACEi/ARBs and even to those with atrial fibrillation (AF). Thus, withdrawing BBs without solid evidence from large randomized trials would not be ideal.

Source: link.springer.com/article/10.1007/s00392-024-02451-0