Abstract
Objective: Hypertension is a very common comorbidity in patients with heart failure. Beta-blockers (BB) are the first choice drug together with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) in patients with heart failure with reduced left ventricular ejection fraction (HFrEF), reducing morbidity and mortality. Design and method: Data were collected in the FARmacology and NeuroHumoral Activation Registry (FAR NHL). Patients with chronic heart failure with left ventricular ejection fraction (LVEF) < 50% for at least one month were included. Results: 1,100 patients with a mean age of 65 years, 80.8% male, were included. The mean systolic blood pressure was 128.0 mm Hg, mean diastolic blood pressure was 80.0 mm Hg. Of all patients, 20% received low dose of beta-blocker (LD), 57% medium dose (MD) and 17% high dose (HD), 6.2% did not receive BB. The higher the blood pressure (LD 124/ 77; MD 129/ 80; HD 132/ 82 mm Hg; p < 0.001), LV EF (LD 29.5; MD 30.5; HD 32.0%; p = 0.003), creatinine clearance (LD 78.7; MD 87.8; HD 91.1 ml/min; p = 0.001) or weight of the patients, the higher the BB dose they received (LD 83.2; MD 88.7; HD 93.5 kg; p < 0.001). The lower the NT-proBNP, the higher the BB dose patients received (LD 767; MD 456; HD 314 pg/ml; p < 0.001). The presence of atrial fibrillation (AF) did not affect the BB dose. Patients with AF were more likely to be treated with digoxin or a combination of digoxin and BB than patients without AF (p < 0.001). Conclusions: According to FAR NHL registry, almost 94% of patients with HFrEF receive BB. A total of 17% of patients take the target dose of BB. If a patient has BB, he/she is treated with the recommended preparation in more than 99% of cases. The more severe the disease, as reflected by lower BP, creatinine clearance, LV EF, weight or higher NT-proBNP, the lower the dose of beta-blockers the patient receives and tolerates.
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