Tolerability to beta-blocker therapy among heart failure patients in clinical practice.

Abstract:

BACKGROUND:Although beta-blockers were well-tolerated by heart failure (HF) patients in clinical trials, tolerability of these drugs in a general population of HF patients is not well-described. METHODS:We studied a total of 308 encounters with beta-blockers therapy in 268 ambulatory HF patients. Side effects and frequency and predictors of discontinuation of therapy were studied. Independent predictors of discontinuation were assessed. RESULTS:Weight gain (59%), fatigue (56%), dizziness (41%), and dyspnea (29%) were the most common side effects. Fifty-one patients (19%) were discontinued on therapy with any 1 particular beta-blocker. Fatigue (30%) and hypotension (28%) were the most common reasons for discontinuation. Forty (78%) of these were given a trial with a different beta-blocker. Of these, 22 (55%) attempts with a different beta-blocker were tolerated. Thus the overall absolute discontinuation rate was only 7% for patients who were given a trial with different beta-blockers or 11% for the entire study population. Independent predictors of discontinuation of therapy included advanced symptoms, nonischemic etiology, history of pulmonary disease, and higher diuretic doses. CONCLUSION:Side effects with beta-blockers in a general population of HF patients are common; however, with changes in medical management, most patients can tolerate them eventually. In case of intolerance to one kind, a trial with a different beta-blocker is indicated.

journal_name

J Card Fail

authors

Butler J,Khadim G,Belue R,Chomsky D,Dittus RS,Griffin M,Wilson JR

doi

10.1054/jcaf.2003.34

keywords:

subject

Has Abstract

pub_date

2003-06-01 00:00:00

pages

203-9

issue

3

eissn

1071-9164

issn

1532-8414

pii

S1071916403000459

journal_volume

9

pub_type

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