Effects of bisoprolol treatment for chronic heart failure initiated and followed up by primary care physicians.
Primary care physicians prescribe beta-blockers for chronic heart failure infrequently. The aims of the study were to assess the effects of beta-blocker treatment in out-clinic patients with regard to NYHA class and frequency of adverse events. Beta-blocker treatment was initiated and followed up by primary care physicians.


METHODS
Chronic heart failure patients already treated with ACE-inhibitors and diuretics were included. The 24-week follow-up consisted of a titration phase followed by a maintenance phase. The patients received the beta-blocker bisoprolol with an initial dose of 1.25 mg and a maximal dose of 10 mg.


RESULTS
NYHA class II, III and IV had 174, 146, and one patient, respectively. Treatment duration lasted 189+/-73 days with a maximal bisoprolol dose of 7.2+/-3.2 mg. Sixty-one percent of the patients tolerated at least 7.5 mg bisoprolol. The NYHA class improved from 2.4+/-0.5 at baseline to 1.8+/-0.6 at week 24 (P<0.001). At final assessment, 74% of the patients showed an improvement. The number of permanent treatment withdrawals was 57 (17%). Death occurred in six patients and hospitalisation in 38 patients.


CONCLUSIONS
Bisoprolol treatment in patients with chronic heart failure was effectively and safely carried out by primary care physicians.
Schuchert
A
A
Medical Clinic III, University-Hospital Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany. schuchert@uke.uni-hamburg.de
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017298:Bisoprolol / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies
D000319:Adrenergic beta-Antagonists; D017298:Bisoprolol