The Impact of Treatment with Beta-Blockers upon Mortality in Chronic Heart Failure Patients

  • Borjanka Taneva University Clinic of Cardiology, Ss Cyril and Methodius University of Skopje, Skopje
  • Daniela Caparoska University Clinic of Toxicology and Urgency Medicine, Ss Cyril and Methodius University of Skopje, Skopje
Keywords: heart failure, beta-blockers, mortality, combined outcome, relative risk reduction


BACKGROUND: Besides the conventional therapy for heart failure, the diuretics, cardiac glycosides and ACE-inhibitors, current pharmacotherapy includes beta-blockers, mainly because of their pathophysiological mechanisms upon heart remodeling.

AIM: The study objective was to assess the cardiovascular mortality in the beta-blocker therapy group and to correlate it with the mortality in the control group as well as to correlate the combined outcome of death and/or hospitalization for cardiovascular reason between the two groups.               

MATERIALS AND METHODS: The study included 113 chronic heart failure patients followed up for a period of 18 months. The therapy group received conventional therapy plus the target dose of beta blockers, and the control group received the conventional therapy only. The therapy group was divided in three separate subgroups in terms of the type of beta-blocker (Metoprolol subgroup, Bisoprolol and Carvedilol subgroup). To compare the mortality and the combined outcome, the RRR (relative risk reduction) and NNT (number needed to treat) were used, as well as the survival analysis by Kaplan-Meier.

RESULTS: The results showed the following: in regards of the cardiovascular mortality, the relative risk for death in the therapy group was 34%, which, though statistically not significant, is of great clinical significance. In regards of the combined outcome (death and/or number of hospitalizations) the results showed a RRR of 40% in the therapy group compared to the control group, which is statistically highly significant.

CONCLUSION: The study confirmed that patients with stable chronic heart failure, treated with optimal doses of beta-blockers, show a significant reduction of the risk from death as well as combined outcome (death and/or number of hospitalizations).


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Eriksson H. Heart failure: a growing public health problem. J Intern Med. 1995;237:135-41.


Gomes UC, Cleland JG. Heart failure. Eur J Heart Fail. 1999;1:301-2.

O'Rourke RA. Beta-adrenergic blocking agents or angiotensin-converting enzyme inhibitors, or both, for post-infarction patients with left ventricular dysfunction. J Am Coll Cardiol. 1997;29:237-239.


Olsen SL, Gilbert EM, REnlund DG, Taylor DO, Yanowitz FD, Bristow MR. Carvedilol improves left ventricular function and symptoms in chronic heart failure: a double-blind randomized study. J Am Coll CArdiol. 1995;25:1225-1231.

Sharpe N. Benefit of Bets-blockers for heart failure:proven in 1999. Lancet. 1999;353:1988-9.

Lechat P. for the CIBIS II Scientific Committee. Design of the Cardiac Insufficiency Bisoprolol Study II (CIBIS II). Funcam Clin Phbarmacol. 1997;11(2):138-42.

MERIT-HF Study Group. Effect of Metoprolol CR/XL in chronic heart failure. Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet. 1999;353:2001-7.

Olsen SL, Gilbert EM, Renlun DG, Taylor DO, Yanowitz FD, Bristow MR. Carvedilol improves left ventricular function and symptoms in chronic heart failure. Am Coll Cardiol. 1997;29:237-239.

The CAPRICORN Investigators. Effect of carvedilol on outcome after myocardial infarction in patients with left ventricular dysfunction: the CAPRICORN randomized trial. Lancet. 2001;357:1385-90.

Chatterjee S. Benefits of Beta blockers in patients with heart failure and reduced ejection fraction: network meta-analysis. BMJ. 2013;346:f355.

PMid:23325883 PMCid:PMC3546627

How to Cite
Taneva B, Caparoska D. The Impact of Treatment with Beta-Blockers upon Mortality in Chronic Heart Failure Patients. Open Access Maced J Med Sci [Internet]. 2016Feb.8 [cited 2020Nov.29];4(1):94-7. Available from:
B - Clinical Sciences