Risk for death was 18% lower for every 5 bpm reduction with β-blocker treatment.
We don’t know whether β-blocker dose or the magnitude of heart rate reduction is most important to reap mortality benefits of β-blockade in patients with heart failure. To answer this question, investigators performed a systematic review of 23 randomized trials in which heart rate was reported at baseline and at the end of dose titration.
β-blocker treatment was associated with lower mortality (relative risk, 0.76) during follow-ups of 3 to 24 months. A median reduction of 15 beats per minute was associated with lower mortality than was a median reduction of 8 bpm (RR, 0.64 vs. 0.91). Risk for death was 18% lower for every 5 bpm reduction with β-blocker treatment. The achieved β-blocker dose was not associated significantly with mortality.