Tolerability to β-blocker therapy among heart failure patients in clinical practice

Javed Butler, Ghazanfar Khadim, Rhonda Belue, Don Chomsky, Robert S. Dittus, Marie Griffin, John R. Wilson

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Background: Although β-blockers were well-tolerated by heart failure (HF) patients in clinical trials, tolerability of these drugs in a general population of HF patients is not well-described. Methods: We studied a total of 308 encounters with β-blockers therapy in 268 ambulatory HF patients. Side effects and frequency and predictors of discontinuation of therapy were studied. Independent predictors of discontinuation were assessed. Results: Weight gain (59%), fatigue (56%), dizziness (41%), and dyspnea (29%) were the most common side effects. Fifty-one patients (19%) were discontinued on therapy with any 1 particular β-blocker. Fatigue (30%) and hypotension (28%) were the most common reasons for discontinuation. Forty (78%) of these were given a trial with a different β-blocker. Of these, 22 (55%) attempts with a different β-blocker were tolerated. Thus the overall absolute discontinuation rate was only 7% for patients who were given a trial with different β-blockers or 11% for the entire study population. Independent predictors of discontinuation of therapy included advanced symptoms, nonischemic etiology, history of pulmonary disease, and higher diuretic doses. Conclusion: Side effects with β-blockers in a general population of HF patients are common; however, with changes in medical management, most patients can tolerate them eventually. In case of intolerance to one kind, a trial with a different β-blocker is indicated.

Original languageEnglish (US)
Pages (from-to)203-209
Number of pages7
JournalJournal of Cardiac Failure
Volume9
Issue number3
DOIs
StatePublished - Jun 2003

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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