Cristodorescu R, Darabantiu D, Christodorescu Ruxandra M, Tomescu Mirela, Lighezan D, Pascu Florica, Branea I D
Cardiology Department, City Hospital, Timişoara, Romania.
Rom J Intern Med. 2004;42(1):103-10.
The beta blockers (BB) being less prescribed in elderly patients (P) with heart failure (HF), the aim of this study was to assess the effectiveness and tolerance of BB (meteoprolol, bisoprolol or carvedilol) given on the top of the conventional therapy in HF due to LV systolic dysfunction in P > or = 70 year (n=57, group 1) and < 70 year (n=101, group 2). Differences in baseline clinical characteristics between the 2 groups were not significant. The BB doses given in group 1 P was lower but the difference was significant for bisoprolol only. Intolerance to BB imposing withdrawal occurred in 12% of group 1 P and in 10% group 2 P (p>0.05). Symptomatic improvement expressed as a significant decreases in NYHA class was observed in both groups. Readmission for worsening HF was needed in 42% vs. 39% while 1 year mortality rate was 11.4% vs. 10.4% in group 1 and 2 P respectively (p>0.05).
BB are tolerated and seem to be effective in most elderly P with HF. Therefore, BB should be tried in all HF P without contraindication irrespective of age.
β受体阻滞剂（BB）在≥70岁（n = 57，第1组）和＜70岁（n = 101，第2组）的左心室收缩功能障碍所致心力衰竭（HF）老年患者（P）中使用较少。本研究的目的是评估在传统HF治疗基础上加用BB（美托洛尔、比索洛尔或卡维地洛）对上述患者的有效性和耐受性。两组患者的基线临床特征差异不显著。第1组P使用的BB剂量较低，但仅比索洛尔的差异具有显著性。第1组12%的P和第2组10%的P因不耐受BB而停药（p>0.05）。两组均观察到纽约心脏协会（NYHA）分级显著降低所表示的症状改善。第1组和第2组P因HF恶化再次入院的比例分别为42%和39%，1年死亡率分别为11.4%和10.4%（p>0.05）。
BB在大多数老年HF患者中耐受性良好且似乎有效。因此，对于所有无禁忌证的HF患者，无论年龄大小，均应尝试使用BB。
