Higher β-Blocker Dose Linked to Lower Mortality Risk
Effect is larger in chronic heart failure patients with diabetes than CHF patients without diabetes
TUESDAY, Nov. 21, 2017 (HealthDay News) -- An increased β-blocker dose is associated with a greater prognostic advantage in patients with chronic heart failure (CHF) and diabetes than in those with CHF but no diabetes, according to a study published online Oct. 25 in Diabetes Care.
Klaus K. Witte, M.D., from the University of Leeds in the United Kingdom, and colleagues assessed the impact of β-blockers and angiotensin-converting enzyme inhibitors (ACEIs) on mortality in CHF patients with and without diabetes in a prospective cohort study. They recruited 1,797 patients with CHF from 2006 to 2014, and mean follow-up was four years.
The researchers found that patients with diabetes were prescribed larger doses of β-blockers and ACEIs compared to patients without diabetes. Lower mortality was seen with increasing β-blocker dose in both patients with diabetes (8.9 percent per mg/day) and without diabetes (3.5 percent per mg/day), although the effect was greater in people with diabetes (interaction P = 0.027). Similarly, increasing ACEI dose was associated with lower mortality in both patients with diabetes (5.9 percent per mg/day) and without diabetes (5.1 percent per mg/day), with similar effect size in the groups (interaction P = 0.76).
"Increasing β-blocker dose is associated with a greater prognostic advantage in CHF patients with diabetes than without diabetes," the authors write.
Two authors disclosed financial ties to the pharmaceutical and medical device industries.