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Cited by 172Heart Failure Treatment and ManagementHeart rate and cardiovascular healthCardiovascular Function and Risk Factors

Beta-adrenergic blocking agent use and mortality in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: a post hoc analysis of the Studies of Left Ventricular Dysfunction

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Exner, Derek V, Dries, Daniel L, Waclawiw, Myron A, Shelton, Brent, Domanski, Michael J·1999·Journal of the American College of Cardiology
DOI 10.1016/s0735-1097(98)00675-5
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Abstract

Objectives This analysis was performed to assess whether beta-adrenergic blocking agent use is associated with reduced mortality in the Studies of Left Ventricular Dysfunction (SOLVD) and to determine if this relationship is altered by angiotensin-converting enzyme (ACE) inhibitor use. Background The ability of beta-blockers to alter mortality in patients with asymptomatic left ventricular dysfunction is not well defined. Furthermore, the effect of beta-blocker use, in addition to an ACE inhibitor, on these patients has not been fully addressed. Methods This retrospective analysis evaluated the association of baseline beta-blocker use with mortality in 4,223 mostly asymptomatic Prevention trial patients, and 2,567 symptomatic Treatment trial patients. Results The 1,015 (24%) Prevention trial patients and 197 (8%) Treatment trial patients receiving beta-blockers had fewer symptoms, higher ejection fractions and different use of medications than patients not receiving beta-blockers. On univariate analysis, beta-blocker use was associated with significantly lower mortality than nonuse in both trials. Moreover, a synergistic reduction in mortality with use of both a beta-blocker and enalapril was suggested in the Prevention trial. After adjusting for important prognostic variables with Cox multivariate analysis, the association of beta-adrenergic blocking agent use with reduced mortality remained significant for Prevention trial patients receiving enalapril. Lower rates of arrhythmic and pump failure death and risk of death or hospitalization for heart failure were observed. Conclusions The combination of a beta-blocker and enalapril was associated with a synergistic reduction in the risk of death in the SOLVD Prevention trial.

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  • Subsequent retrospective analyses from SOLVD and SAVE revealed that concomitant use of b-blockers was associated with decreased risk of progression to symptomatic heart failure.

    “Subsequent retrospective analyses from both trials revealed that concomitant use of b-blockers was associated with decreased risk of progression to symptomatic heart failure (280,281).”

    From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [280]

  • In retrospective analyses from the SOLVD and SAVE trials, concomitant use of β-blockers was associated with decreased risk of progression to symptomatic heart failure.

    “Subsequent retrospective analyses from both trials revealed that concomitant use of β-blockers was associated with decreased risk of progression to symptomatic heart failure (277,278).”

    From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [277]

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Authors
Exner, D. V., Dries, D. L., Waclawiw, M. A., Shelton, B., & Domanski, M. J.
Affiliations
  • National Institutes of Health (US)
  • National Heart, Lung, and Blood Institute (US)
  • Wake Forest University Health Sciences (US)
Corresponding author
Exner, Derek V
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
1999-03
Volume
33
Issue
4
Pages
916-923
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/s0735-1097(98)00675-5
OpenAlex
W1967454817
Cited by
172
References
44
Citations by year
2026: 5 · 2025: 7 · 2024: 3 · 2023: 5 · 2022: 7 · 2021: 3 · 2020: 5 · 2019: 6 · 2018: 1 · 2017: 7 · 2016: 4 · 2015: 10 · 2014: 7 · 2013: 8 · 2012: 8
FWCI
5.35
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
beta-adrenergic blocking agents, left ventricular systolic dysfunction, mortality, enalapril, ACE inhibitors, combination therapy, asymptomatic heart failure, heart failure hospitalization, arrhythmic death, pump failure
MeSH terms
Adrenergic beta-Antagonists, Adult, Aged, Angiotensin-Converting Enzyme Inhibitors, Cause of Death, Drug Therapy, Combination, Enalapril, Female, Hemodynamics, Humans, Male, Middle Aged, Retrospective Studies, Systole, Survival Rate, Ventricular Function, Left, Ventricular Dysfunction, Left

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