Letters β blockers for heart failure

Research into “real world” older patients is needed

BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i3136 (Published 07 June 2016) Cite this as: BMJ 2016;353:i3136
  1. Conal J Cunningham, consultant geriatrician
  1. Falls and Blackout Unit, St James's Hospital, Dublin 8, Republic of Ireland
  1. ccunningham{at}stjames.ie

Kotecha and colleagues’ meta-analysis establishes that β blockers are beneficial in patients aged 40-85 with heart failure and reduced ejection fraction who are able to tolerate them. In the original trials most patients seemed to tolerate these drugs.1

But it does not tell us how well older people in clinical practice can tolerate β blockers, and the authors seem to extrapolate beyond their data. All the randomised …

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