Open AccessA Review of the External Validity of Clinical Trials with Beta-Blockers in Heart Failure
Author(s) -
Pupalan Iyngkaran,
Samia R. Toukhsati,
Merlin C. Thomas,
Michael Jelinek,
David L. Hare,
John D. Horowitz
Publication year - 2016
Publication title -
clinical medicine insights cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.634
H-Index - 21
ISSN - 1179-5468
DOI - 10.4137/cmc.s38444
Subject(s) - medicine , atrial fibrillation , heart failure , randomized controlled trial , medline , diabetes mellitus , clinical trial , intensive care medicine , disease , management of atrial fibrillation , placebo , physical therapy , cardiology , alternative medicine , pathology , political science , law , endocrinology
Beta-blockers (BBs) are the mainstay prognostic medication for all stages of chronic heart failure (CHF). There are many classes of BBs, each of which has varying levels of evidence to support its efficacy in CHF. However, most CHF patients have one or more comorbid conditions such as diabetes, renal impairment, and/or atrial fibrillation. Patient enrollment to randomized controlled trials (RCTs) often excludes those with certain comorbidities, particularly if the symptoms are severe. Consequently, the extent to which evidence drawn from RCTs is generalizable to CHF patients has not been well described. Clinical guidelines also underrepresent this point by providing generic advice for all patients. The aim of this review is to examine the evidence to support the use of BBs in CHF patients with common comorbid conditions.
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