title: [How beta-blockers are used in Spain? Analysis of limitations in their use in internal medicine and cardiology: CARACTER-BETA study].
abstract: OBJECTIVE
  Beta-blocker treatment has a class I indication, level of evidence A, in guidelines for the treatment of heart failure, ischemic heart disease, and atrial fibrillation. However, beta-blocker use continues to be less than optimal. In this study, beta blocker use in Spain is analyzed in patients with heart failure, ischemic heart disease, and atrial fibrillation.
  
  
  METHODS
  Observational, epidemiologic, cross-sectional, multicenter study including 1608 patients with heart failure, ischemic heart disease, and/or atrial fibrillation, recruited in 150 healthcare centers by cardiologists and internal medicine specialists.
  
  
  RESULTS
  Cardiologists enrolled 78.6% patients and internal medicine specialists 21.4%; 25.8% were recruited at hospital discharge and 74.2% at outpatient centers. Men accounted for 77% of the sample, and age was 68 (12) years. Of the total, 73% had ischemic heart disease, 42% heart failure, and 36% atrial fibrillation (multiresponse variable). Beta blockers were given to 82.8% of those consulting in cardiology compared to 71.6% of those treated in internal medicine (P<.0001). By pathology, the prescription rate was 85.1% of patients with ischemic heart disease, 77.0% of those with heart failure, and 72.4% of those with atrial fibrillation. Cardiology prescribed significantly more beta blockers for ischemic heart disease and heart failure than did internal medicine. Multivariate analysis showed that beta blocker use increased when the patient had ischemic heart disease, was treated by a cardiologist, and had dyslipidemia, stroke, and/or left ventricular hypertrophy. beta blocker use decreased with age and with a history of bronchospasm, asthma, bradycardia, chronic obstructive pulmonary disease, and/or intermittent claudication.
  
  
  CONCLUSIONS
  There is still room for improvement in beta blocker prescription in Spain for patients with ischemic heart disease, heart failure, and/or atrial fibrillation.
authors: Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors: Xavier
authors: X
authors: Garcia-Moll
authors: Lorenzo
authors: L
authors: Fácila
authors: Pedro
authors: P
authors: Conthe
authors: Antonio
authors: A
authors: Zapata
authors: Remei
authors: R
authors: Artigas
authors: Vicente
authors: V
authors: Bertomeu
authors: José Ramón
authors: JR
authors: González-Juanatey
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D001281:Atrial Fibrillation / Q000188:drug therapy; D002309:Cardiology / Q000706:statistics & numerical data*; D000075202:Contraindications; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000188:drug therapy; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy; D011237:Predictive Value of Tests; D018401:Sample Size; D013030:Spain / Q000453:epidemiology
chemical_list: D000319:Adrenergic beta-Antagonists