Which Beta-Blocker is Best for Patients with Heart Failure?

Treatment of systolic heart failure with beta-blockers has been shown to reduce cardiovascular morbidity and mortality, but which beta-blocker to use is the subject of debate. In two independent observational studies, investigators assessed the comparative effectiveness of different beta-blockers in patients with heart failure.

In the first study, the authors identified nearly 12,000 patients aged 65 or older in North Carolina Medicaid and Medicare records from 2001 through 2004 who had had at least one hospitalization for heart failure. The researchers assessed mortality from 30 days to 1 year after discharge in patients taking the evidence-based beta-blockers (EBBBs) carvedilol, metoprolol succinate, and bisoprolol (23%); in patients takin…