Beta-Blockers and Mortality Reduction in Heart Failure: A Systematic Review of Randomized Controlled Trials
Impact of Beta-Blockers on Heart Failure
DOI:
https://doi.org/10.69750/dmls.01.08.078Keywords:
beta-blockers, heart failure, mortality, hospital admissions, cardiovascular mortality, randomized controlled trialsAbstract
Background: Heart failure is a leading cause of morbidity and mortality. This systematic review evaluates beta blockers' effects on all-cause mortality, cardiovascular mortality, and hospital admissions in heart failure, synthesizing data from over 50 randomized controlled trials.
Methods: Using PRISMA principles, the data regarding the effect of beta blockers on heart failure mortality and hospitalizations were synthesized. Extensive database searches (PubMed, Embase, Cochrane Library, and Web of Science) and manual reference checks were used to identify randomized controlled studies that compared beta blockers with placebo or conventional treatment in adults. The quality of data extraction process was evaluated according to the Cochrane Risk of Bias tool following the guidelines. Heterogeneity was assessed (I2), sensitivity analyses guaranteed robustness, and random-effects meta-analyses quantified results. Transparency was guaranteed via PROSPERO registration.
Results: Beta-blockers were linked to a 29% decrease in cardiovascular mortality (OR 0.71, 95% CI 0.64–0.79, p< 0.05) and a 33% decrease in all cause mortality (OR 0.67, 95% CI 0.59–0.76, p < 0.05) when compared to alternative therapies. Additionally, beta-blocker-treated patients saw a 37% decrease in hospital admissions (OR 0.63, 95% CI: 0.56–0.71, p < 0.05). The class impact of beta blockers in heart failure treatment is supported by these advantages which were constant across subgroups and beta blocker types.
Conclusion: This systematic review corroborates the well-established benefit of beta blockers in lowering mortality and hospitalizations in heart failure patients, particularly with HFrEF. The findings support the use of beta blockers as a cornerstone of heart failure therapy and there is a need for further research to optimize the use of beta blockers in combination with other emerging therapies.
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