[Safety and tolerance of beta-blocker treatment in elderly patients with heart failure. BETANIC study]

Background and objective: Prescription of beta-blockers (BB) in elderly patients with heart failure (HF) is very low, and it probably owes to an excessive concern about the risk of adverse reactions. The objective of our study was to determine the safety and tolerance of BB in elderly patients with HF in an Internal Medicine clinical practice.

Material and methods: This observational prospective study of clinical practice included 119 patients older than 70 years with HF evaluated in 10 Internal Medicine services. Patients must have started treatment with BB (carvedilol or bisoprolol) within the last month. After 6 months of follow-up, the percentage of patients on BB, the dose achieved and the causes of withdrawal were analyzed.

Results: At the end of the study, 100 patients (84%) were on BB treatment. There were 3 deaths (2.5%), none related to BB use, and 6 losses to follow-up (5%). The treatment was stopped in 10 patients (8.4%). Maximum dose was achieved in 38.7% of the patients. Adverse reactions responsible for treatment withdrawal were: symptomatic hypotension (3 cases; 2.5%); asymptomatic hypotension (1 case; 0.8%); heart failure (2 cases; 1.7%); bradycardia (2 cases; 1.7%); bronchospasm (1 case; 0.8%); and unknown cause (1 case; 0.8%).

Conclusions: BB are excellently tolerated in elderly patients with HF treated in an Internal Medicine setting.