Thursday, July 30, 2009

Beta blocker titration in heart failure: base it on heart rate reduction

From a meta-analysis in Annals:

For every heart rate reduction of 5 beats/min with β-blocker treatment, a commensurate 18% reduction (CI, 6% to 29%) in the risk for death occurred. No significant relationship between all-cause mortality and β-blocker dosing was observed…

Conclusion: The magnitude of heart rate reduction is statistically significantly associated with the survival benefit of β-blockers in heart failure, whereas the dose of β-blocker is not.

This differs from guideline recommendations, which are based on the doses used in trials.

Via Hospital Medicine quick Hits.

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