DEcIDE Research: Beta Blocker Therapy in Heart Failure

Chronic congestive heart failure (CHF) is common in the Medicare population and has a substantial impact on quality of life and longevity. A large body of clinical evidence has shown that appropriate use of several types of medication can improve both patient functioning and mortality rates for CHF.

One class of these medications are known as beta (β) blockers. There has been clinical uncertainty about whether some drugs in this class are more effective in preventing deaths and other complications than other drugs. There have been few head-to-head studies comparing one β blocker to another, so the evidence base to help guide choosing a β blocker has been limited.

To help address this evidence gap, AHRQ’s Effective Health Care Program commissioned the HMO Research Network DEcIDE Center to conduct a study comparing rehospitalization rates among people with CHF. The study compared people treated with one of three commonly used β blockers: atenolol, carvedilol, and metoprolol tartrate (the conventional short-acting metoprolol preparation). It also compared people who were not treated with a β blocker with those who were treated with a β blocker. The patient cohort was obtained from two large health plan databases.

After controlling for socio-demographic factors, coexistent illnesses, and treatment with other types of medication, the study found that there were no significant differences in rehospitalization rates among the patient groups treated with each type of β blocker. The findings support the role of β blockers in the management of heart failure and suggest that atenolol, metoprolol tartrate, and carvedilol may be similarly effective in preventing rehospitalization within 12 months. The complete DEcIDE report is available here.