Increasing β-blocker Dose May Lower Death Risk in CHF With Diabetes
Effect is larger in chronic heart failure patients with diabetes than CHF patients without diabetes.
(HealthDay News) -- An increased β-blocker dose is associated with a greater prognostic advantage in patients with chronic heart failure (CHF) and diabetes than in those with CHF but no diabetes, according to a study published online in Diabetes Care.
Klaus K. Witte, MD, from the University of Leeds in the United Kingdom, and colleagues assessed the impact of β-blockers and angiotensin-converting enzyme inhibitors (ACEIs) on mortality in CHF patients with and without diabetes in a prospective cohort study. They recruited 1797 patients with CHF from 2006 to 2014, and mean follow-up was 4 years.
The researchers found that patients with diabetes were prescribed larger doses of β-blockers and ACEIs compared to patients without diabetes. Lower mortality was seen with increasing β-blocker dose in both patients with diabetes (8.9% per mg/day) and without diabetes (3.5% per mg/day), although the effect was greater in people with diabetes (interaction P=0.027). Similarly, increasing ACEI dose was associated with lower mortality in both patients with diabetes (5.9% per mg/day) and without diabetes (5.1% per mg/day), with similar effect size in the groups (interaction P=0.76).
"Increasing β-blocker dose is associated with a greater prognostic advantage in CHF patients with diabetes than without diabetes," the authors write.
Two authors disclosed financial ties to the pharmaceutical and medical device industries.
Witte KK, Drozd M, Walker AMN, et al. Mortality Reduction Associated With β-Adrenoceptor Inhibition in Chronic Heart Failure Is Greater in Patients With Diabetes. Diab Care 2017 Oct doi: 10.2337/dc17-1406