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The effects of cardiovascular medications in general patient populations do not necessarily translate to patients with end-stage renal disease (ESRD). In this study from an integrated California health system, researchers examined the relation between β-blocker use and mortality in ESRD patients who transitioned to chronic dialysis and who had documented histories of heart failure. About 2100 users of β-blockers were compared with 1400 propensity-score–matched nonusers.
During the 6 months after initiating dialysis, overall mortality was about 13%. Users of β-blockers were significantly less likely to die than were nonusers (hazard ratio, 0.79). The lower mortality was significant in patients with ejection fraction >40% (HR, 0.75) but not in…