Mortality and morbidity of newly diagnosed heart failure with preserved systolic function treated with β-blockers: a propensity-adjusted case-control populational study.

Background: The effect of treatment with β-blockers on the prognosis of patients newly diagnosed with heart failure with preserved systolic function (HF-PSF) is unknown.

Objectives: To analyze the relationship of commencing treatment with the β-blockers bisoprolol or carvedilol (CT-βB) with the mortality and the morbidity of newly diagnosed HF-PSF.

Methods: Prospective propensity-adjusted cohort study over 5 years on 1085 adults diagnosed with HF-PSF for the first time, in an integrated university-based health organization in Spain. The independent relationship between CT-βB and mortality and morbidity was analyzed, stratifying patients for comorbidity, after a multivariable adjustment for potential confounders.

Results: The 378 patients (34.8%) who CT-βB were more frequently older women, with more cardiovascular comorbidity. Of the total patients 554 (51.0%) died, and 711 (65.5%) were hospitalized. Using an intent-to-treat approach, CT-βB was associated with a lower risk of mortality (all-cause: RR [CI 95%] 0.37 [0.21 to 0.50], and cardiovascular: 0.31 [0.18 to 0.45]), and a lower age- and sex-adjusted hospitalization rate (per 100 persons/year), 13.6 vs. 19.2, (P<0.001 in all cases), even after adjustment for the propensity to take β-blockers, or other medications, comorbidities, and other potential confounders.

Conclusions: In this observational study, commencing treatment with the β-blockers bisoprolol or carvedilol is associated with a reduced mortality and morbidity of patients with newly diagnosed heart failure with preserved systolic function.