Patients with HFpEF would benefit more from beta-blockers vs. calcium channel blockers
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Key takeaways:
- Beta-blockers more effectively reduce risk for death or hospitalization in people with HFpEF compared with calcium channel blockers.
- Calcium channel blockers also reduce the risk for adverse outcomes in HFpEF.
Beta-blockers may reduce risk for death or hospitalization for people with HF with preserved ejection fraction more effectively than calcium channel blockers, according to data from a meta-analysis of randomized controlled trials.
“Patients with HFpEF routinely get beta-blockers despite a lack of clinical evidence supporting their use,” Shengjun Qiu, MM, Department of Medical College, Wuhan Railway Vocational College of Technology in Wuhan, China, and colleagues wrote in Clinical Cardiology. “Recent clinical trials have shown that more than 75% of patients with HFpEF are being treated with beta-blockers. Similarly, recent studies suggested that HFpEF patients who used calcium channel blockers had better results.”
Image: Adobe Stock
Qiu and colleagues analyzed data from 12,940 adults with HFpEF from 10 randomized controlled trials that assessed the efficacy of beta-blockers and calcium channel blockers, including all‐cause mortality and hospitalization due to HF. Follow-up times ranged from 1 to 42 months.
Compared with placebo, beta-blockers and calcium channel blockers both significantly reduced risk for all‐cause mortality and hospitalization. However, beta-blockers were associated with greater benefits for all‐cause mortality (RR = 0.6; 95% CI, 0.43-0.83; P = .002) and hospitalization (RR = 0.54; 95% CI, 0.37-0.8; P = .002) compared with calcium channel blockers, which have an RR of 0.77 for all-cause mortality (95% CI, 0.6-0.98; P = .03) and RR of 0.63 for hospitalization (95% CI, 0.44-0.9; P < .00001). Researchers noted high heterogeneity between the studies (I2 > 70%). The researchers also noted that the studies used varying definitions of HFpEF.
“We found that the use of beta-blockers and calcium channel blockers for HFpEF significantly reduced the risk of all‐cause mortality and hospitalization compared with placebo,” the researchers wrote. “Patients with HFpEF would benefit more from treatment with beta-blockers than calcium channel blockers, according to this meta‐analysis.”
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