Beta blockers, also spelled β-blockers, are a class of medications that are used to manage abnormal heart rhythms, and to protect the heart from a second heart attack after a first heart attack. They are also widely used to treat high blood pressure.
Patients aged ≥ 75 years who receive a beta-blocker after heart failure with reduced ejection fraction (HFrEF) hospitalization have significantly lower 90-day mortality and readmission rates.
Several studies have shown it may also be useful to diminish the risk of Alzheimer disease.
This study aimed to determine the association between beta-blocker use and outcomes among patients with reduced ejection fraction and Alzheimer's disease and related dementias.
Using a random 40% sample of Medicare Parts A, B, and D data the authors identified 357,030 patients with ≥1 hospitalization for reduced ejection fraction between 2008 and 2018. 12.7% of those patients had dementia.
Patients with reduced ejection fraction and dementia had higher 90-day and 1-year mortality compared to patients with reduced ejection fraction-only.
Discontinuing beta-blocker was associated with a 2.2-fold higher risk of 90-day mortality among patients with HF-only and a 2.- fold higher risk of 90-day mortality among patients with reduced ejection fraction + dementia.
Not starting a beta-blocker was associated with a 1.8-fold higher risk of 90-day mortality among patients with reduced ejection fraction-only and a 1.7-fold higher risk of 90-day mortality among patients with reduced ejection fraction + dementia. Similar risks were seen at 1 year.
In conclusion beta-blocker therapy was found to be associated with significantly lower short and long-term mortality rates among all patients with reduced ejection fraction.