Author + information
- Received January 8, 2003
- Revision received June 18, 2003
- Accepted June 25, 2003
- Published online October 15, 2003.
- ↵*Reprint requests and correspondence:
Dr. Bibiana Cujec, Division of Cardiology, University of Alberta, 2C2.39 WMC, Edmonton, Alberta, Canada T6G 2B7.
Objectives We sought to evaluate the common utilization of beta-blockers and angiotensin-converting enzyme (ACE) inhibitors or receptor blockers (RBs) in congestive heart failure (CHF).
Background We assessed the association between prescriptions of beta-blockers and ACE inhibitors or RBs within three months after hospitalization and mortality for newly diagnosed CHF in Alberta, Canada seniors (age 65 years and older).
Methods Administrative hospital discharge abstracts and drug data during October 1, 1994, to December 31, 1999, were analyzed.
Results There were 11,854 hospitalizations for newly diagnosed CHF. The use of beta-blockers within three months after hospitalization increased from 7.3% in 1994–1995 to 20.9% in 1999–2000. The use of ACE inhibitor or RBs within three months after hospitalization increased from 31.0% in 1994–1995 to 44.3% in 1999–2000. Adjusted one-year mortality was lower in seniors with prescriptions for beta-blockers (18.2%; 95% confidence interval [CI] 14.2 to 22.2), ACE inhibitors/RBs (22.3%; 95% CI 20.9 to 23.7), or both (16.6%; 95% CI 13.3 to 20.0), compared with those with no prescriptions (29.9%; 95% CI 28.8 to 31.0). Absolute adjusted risk reduction comparing no prescription with prescription of both beta-blockers or ACE inhibitors/RBs was 13.3% for a relative adjusted risk reduction of 44%.
Conclusions This study of incident CHF hospitalizations among seniors demonstrates an association between decreased mortality and the use of beta-blockers, ACE inhibitors/RBs, or combination of both. The effectiveness of beta-blockers and ACE inhibitors/RBs for CHF should be more broadly tested in clinical trials that recruit older patients and those with diastolic dysfunction.
☆ This work was partially supported by the Alberta Center for Health Service Utilization Research. The opinions and conclusions expressed in this paper are those of the authors, and no endorsement by the Alberta Ministry of Health and Wellness is implied.
- Received January 8, 2003.
- Revision received June 18, 2003.
- Accepted June 25, 2003.
- American College of Cardiology Foundation