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β-blockers prevent cardiovascular-related morbidity and mortality in patients with heart failure and reduced ejection fractions. But does a strong dose-response relation exist between β-blockers and clinical outcomes? In this post hoc analysis of data from a randomized trial of exercise training in New York Heart Association class II–IV heart failure patients, investigators categorized 2331 participants according to their β-blocker doses. Most patients (95%) were receiving β-blockers; the most common daily dose categories were 14- to 25-mg or 26- to 50-mg carvedilol equivalents.
At a mean follow-up of 2.5 years, a piecewise linear relation was seen between β-blocker dose and the combined endpoint of mortality and hospitalization, with an inv…