In this meta-analysis of 23 randomized CHF trials (>95% of patients had systolic dysfunction), pooled analysis showed beta blockers conferred a significant mortality benefit (risk ratio 0.76, CI 0.68-0.84). They did not find an association between mortality and beta blocker dose, but did find a linear association between mortality and heart rate (with an 18% relative risk reduction for every 5 fewer beats per minute). Beta blockers should be titrated by heart rate, not dose, to achieve mortality benefits in patients with systolic CHF (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.