The effectiveness of beta-blockers in women with congestive heart failure.
BACKGROUND
Beta-blockers have been shown to improve survival in patients with congestive heart failure (CHF). However, few studies have looked at the effects of these medications specifically in women.


OBJECTIVE
To determine the effectiveness of beta-blockers in women with CHF.


METHODS
We conducted a retrospective cohort study that used administrative databases of all patients >65 years of age discharged with a diagnosis of CHF between January 1998 and March 2003 in Quebec, Canada. Follow-up information was available until March 31, 2004.


METHODS
The cohort included 27,837 patients. Subjects with filled prescription for a beta-blocker (14,083 users) were compared with those who never filled such prescription (12,254 nonusers). The primary outcome was survival in women and men by beta-blocker use.


RESULTS
There were 14,693 women (52% were prescribed beta-blockers) and 13,144 men (49% were prescribed beta-blockers). Women were older and had more hypertension, whereas men had more myocardial infarction. There was a significant survival benefit with beta-blockers use in both sexes (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.75-0.83 in women, and 0.76, 95% CI 0.72-0.80 in men). Sensitivity analyses adjusting for selection bias showed similar survival benefits in both sexes. Overall, men had a worse survival than women (HR 1.2, 95% CI 1.2-1.3 in men).


CONCLUSIONS
Beta-blockers appear to improve survival from CHF as much in women as in men. Clinical trials involving large numbers of women are necessary to demonstrate potential treatment benefits.
Keyhan
Golyar
G
Division of Clinical Epidemiology, The Research Institute of the McGill University Health Center, 1650 Cedar Avenue, Rm L10-421, Montreal, Quebec, Canada, H3G 1A4.
Chen
Shun-Fu
SF
Pilote
Louise
L
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists