Systematic review of the impact of beta blockers on mortality and hospital admissions in heart failure

Eur J Heart Fail. 2001 Jun;3(3):351-7. doi: 10.1016/s1388-9842(01)00144-1.


Heart failure is a common condition that carries a high burden of mortality and morbidity. Several randomised trials have evaluated the effects of beta blockers in heart failure. This paper gives a systematic overview of published randomised trials of beta blockers in heart failure using standard methods. In all, 22 randomised controlled trials were identified with a total of 10480 patients, and an average of 11 months of treatment. The average age was 61 years and 4% were female. Most studies excluded patients with severe heart failure. Death rates in patients randomised to receive beta blockers compared to controls were 458/5657 (8.0%) and 635/4951 (12.8%) respectively, odds ratio 0.63, 95% CI 0.55-0.72, P<0.00001. Similar reductions were observed for hospital admissions for worsening heart failure (11.3 vs. 17.1%, respectively, odds ratio 0.63) and for the composite outcome of death or heart-failure hospital admission (19.4 vs. 26.9%, respectively, odds ratio 0.66). These results show that beta blockers reduce the risk of mortality or the need for heart-failure hospital admission by approximately one third. Absolute reductions of 5-6% in event rates were observed over approximately 1 year of treatment period. These important benefits should be implemented as a priority, since treatment with beta blockers is inexpensive and heart failure carries a high risk of death and disability. Further information on the effect of beta blockers in elderly patients and women would be helpful.

Publication types

  • Clinical Trial
  • Comparative Study
  • Meta-Analysis
  • Randomized Controlled Trial
  • Review
  • Systematic Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Aged
  • Confidence Intervals
  • Double-Blind Method
  • Endpoint Determination
  • Female
  • Follow-Up Studies
  • Heart Failure / drug therapy*
  • Heart Failure / etiology
  • Heart Failure / mortality*
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Admission*
  • Survival Analysis
  • Treatment Outcome


  • Adrenergic beta-Antagonists