Beta-adrenoceptor antagonists in elderly patients with chronic heart failure: therapeutic potential of third-generation agents

Drugs & Aging
A J Coats

Abstract

Chronic heart failure (CHF) is a common and disabling condition with an incidence and prevalence that increase sharply with age. The median age of presentation of new heart failure cases is > 75 years. Effective treatments, including beta-adrenoceptor antagonists, have been proven in randomised, controlled trials. The average age in these placebo-controlled mortality and morbidity studies of beta-adrenoceptor antagonists in heart failure has, however, been < 63 years, and all patients with an ejection fraction > or = 40% were excluded. This lack of a representative sample of elderly patients with heart failure has raised concerns about extrapolating the available evidence for beta-adrenoceptor antagonists to a more elderly heart failure population. Beta-adrenoceptor antagonists may have a less beneficial effect or even an adverse effect in elderly heart failure patients. There is evidence that beta-adrenoceptor antagonists are less frequently prescribed in elderly CHF patients, and that this lack of treatment is associated with impaired outcomes. Establishing which beta-adrenoceptor antagonists, if any, are effective in elderly CHF is therefore of extreme importance. The elderly have a reduced cardiovascular reserve and may be ...Continue Reading

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Citations

Apr 19, 2007·Cardiovascular Drugs and Therapy·Qiang ZhaoLe-Xin Wang
Jul 28, 2011·Clinical Medicine Insights. Cardiology·Neil A SmartFrancesco Giallauria
Jan 18, 2013·Current Opinion in Cardiology·Michael Chan, Ross Tsuyuki
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