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What resting heart ...
What resting heart rate should one aim for when treating patients with heart failure with a beta-blocker? Experiences from the Metoprolol Controlled Release/Extended Release Randomized Intervention Trial in Chronic Heart Failure (MERIT-HF)
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Gullestad, L. (author)
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- Wikstrand, John, 1938 (author)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Wallenberglaboratoriet,Cardiovascular Institute,Wallenberg Laboratory
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Deedwania, P. (author)
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- Hjalmarson, Åke, 1937 (author)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Wallenberglaboratoriet,Cardiovascular Institute,Wallenberg Laboratory
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Egstrup, K. (author)
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Elkayam, U. (author)
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Gottlieb, S. (author)
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Rashkow, A. (author)
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Wedel, H. (author)
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Bermann, G. (author)
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Kjekshus, J. (author)
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(creator_code:org_t)
- 2005
- 2005
- English.
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In: J Am Coll Cardiol. - 0735-1097. ; 45:2, s. 252-9
- Related links:
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https://gup.ub.gu.se...
Abstract
Subject headings
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- OBJECTIVES: The goal of this study was to explore the question: what resting heart rate (HR) should one aim for when treating patients with heart failure with a beta-blocker? BACKGROUND: The interaction of pretreatment and achieved resting HR with the risk-reducing effect of beta-blocker treatment needs further evaluation. METHODS: Cardiovascular risk and risk reduction were analyzed in five subgroups defined by quintiles (Q) of pretreatment resting HR in the Metoprolol Controlled Release/Extended Release Randomized Intervention Trial in Chronic Heart Failure (MERIT-HF). RESULTS: Mean baseline HR in the 5 Qs were 71, 76, 81, 87, and 98 beats/min; achieved HR 63, 66, 68, 72, and 75 beats/min; and net change -8, -10, -11, -13, and -14 beats/min, respectively. Baseline HR was related to a number of baseline characteristics. Cardiovascular risk was no different in Q1 to Q4 (placebo groups) but increased in Q5 (HR above 90 beats/min). No relationship was observed between the risk-reducing effect of metoprolol controlled release/extended release (CR/XL) and baseline HR in the five Qs of baseline HR, or achieved HR, or change in HR during follow-up, respectively. CONCLUSIONS: Metoprolol CR/XL significantly reduced mortality and hospitalizations independent of resting baseline HR, achieved HR, and change in HR. Achieved HR and change in HR during follow-up were closely related to baseline HR; therefore, it was not possible to answer the question posed. Instead, one has to apply a very simple rule: aim for the target beta-blocker dose used in clinical trials, and strive for the highest tolerated dose in all patients with heart failure, regardless of baseline and achieved HR.
Keyword
- Adrenergic beta-Antagonists/*therapeutic use
- Adult
- Aged
- Aged
- 80 and over
- Chronic Disease
- Delayed-Action Preparations
- Female
- Follow-Up Studies
- Heart Failure
- Congestive/*drug therapy/mortality/*physiopathology
- Heart Rate/*physiology
- Hospitalization
- Humans
- Male
- Metoprolol/*analogs & derivatives/*therapeutic use
- Middle Aged
- Prospective Studies
- Rest/*physiology
- Risk Assessment
- Treatment Outcome
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Gullestad, L.
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Wikstrand, John, ...
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Deedwania, P.
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Hjalmarson, Åke, ...
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Egstrup, K.
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Elkayam, U.
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show more...
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Gottlieb, S.
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Rashkow, A.
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Wedel, H.
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Bermann, G.
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Kjekshus, J.
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show less...
- Articles in the publication
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J Am Coll Cardio ...
- By the university
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University of Gothenburg