McGinlay, M, Straw, S orcid.org/0000-0002-2942-4574, Byrom-Goulthorp, R et al. (5 more authors) (2021) Suboptimal Dosing of β-Blockers in Chronic Heart Failure: A Missed Opportunity? Journal of Cardiovascular Nursing. ISSN 0889-4655
Abstract
Background
The evidence base for the benefits of β-blockers in heart failure with reduced ejection fraction (HFrEF) suggests that higher doses are associated with better outcomes.
Objectives
The aim of this study was to report the proportion of patients receiving optimized doses of β-blockers, outcomes, and factors associated with suboptimal dosing.
Methods
This was a prospective cohort study of 390 patients with HFrEF undergoing clinical and echocardiography assessment at baseline and at 1 year.
Results
Two hundred thirty-seven patients (61%) were receiving optimized doses (≥5-mg/d bisoprolol equivalent), 72 (18%) could not be up-titrated (because of heart rate < 60 beats/min or systolic blood pressure <100 mm Hg), and the remaining 81 (21%) should have been. Survival was similarly reduced in those who could not and should have been receiving 5 mg/d or greater, and patient factors did not explain the failure to attain optimized dosing.
Conclusions
Many patients with HFrEF are not receiving optimal dosing of β-blockers, and in around half, there was no clear contraindication in terms of heart rate or blood pressure.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 Wolters Kluwer Health, Inc. All rights reserved. This is an author produced version of an article published in Journal of Cardiovascular Nursing. Uploaded in accordance with the publisher's self-archiving policy. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Discovery & Translational Science Dept (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Centre for Health Services Research (Leeds) |
Funding Information: | Funder Grant number British Heart Foundation FS/CRTF/20/24071 |
Depositing User: | Symplectic Publications |
Date Deposited: | 07 Jun 2021 10:11 |
Last Modified: | 29 Jul 2022 10:38 |
Status: | Published online |
Publisher: | Lippincott, Williams & Wilkins |
Identification Number: | 10.1097/JCN.0000000000000847 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:174794 |