title: Beta blockers in older persons with heart failure: tolerability and impact on quality of life.
abstract: OBJECTIVE
  To determine tolerability and symptom changes associated with the introduction of bisoprolol treatment in older patients with heart failure.
  
  
  METHODS
  Prospective observational cohort study.
  
  
  METHODS
  Geriatric medicine outpatient department of a university hospital.
  
  
  METHODS
  51 patients (mean age 78 years, range 70-89 years) with stable symptomatic heart failure caused by left ventricular systolic dysfunction.
  
  
  METHODS
  Bisoprolol tablets, 1.25-10.0 mg.
  
  
  METHODS
  Tolerability; changes in symptoms and exercise tolerance.
  
  
  RESULTS
  69% of patients tolerated bisoprolol. Mean tolerated dose was 7.6 mg. There was no change in symptoms or exercise capacity in those who tolerated bisoprolol. Perceived health status and symptoms of anxiety and depression improved during the titration period.
  
  
  CONCLUSIONS
  The rate of withdrawal from bisoprolol treatment in older patients with congestive heart failure was twice that previously reported in younger patients. The mean tolerated dose was similar to that found in trials reporting clinical efficacy. There was no evidence of a negative impact on symptoms or exercise capacity in patients who tolerated bisoprolol.
authors.affiliation: Department of Geriatric Medicine, Sunderland Royal Hospital, University of Newcastle upon Tyne, Sunderland, UK. john.baxter@chs.northy.nhs.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Baxter
authors.forename: A
authors.initials: A
authors.lastname: Spensley
authors.forename: A
authors.initials: A
authors.lastname: Hildreth
authors.forename: G
authors.initials: G
authors.lastname: Karimova
authors.forename: J E
authors.initials: JE
authors.lastname: O'Connell
authors.forename: C S
authors.initials: CS
authors.lastname: Gray
mesh_terms: D000318:Adrenergic beta-Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D017298:Bisoprolol / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D017079:Exercise Tolerance / Q000187:drug effects / Q000502:physiology; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D013607:Tablets; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology
chemical_list: D000318:Adrenergic beta-Agonists; D013607:Tablets; D017298:Bisoprolol