Under-prescription of beta-blockers in older patients with chronic heart failure: an observational study in Vietnam

This study in older hospitalized patients with heart failure aimed to examine: (1) The prevalence of beta-blocker prescription and its associated factors, and (2) The association of beta-blocker prescription with adverse outcomes after discharge. A total of 190 participants were recruited (mean age 75.5,46.8% female). Of these, 55.3% were prescribed beta-blockers during admission. On multivariate logistic regression models, previous myocardial infarction (OR 3.70, 95% CI 1.13–12.10) was associated with increased likelihood of prescription, while chronic obstructive pulmonary disease (OR 0.14, 95% CI 0.03–0.69), chronic kidney disease (OR 0.31, 95% CI 0.15–0.64), and heart rate under 70 (OR 0.39, 95% CI 0.17–0.89) were associated with reduced likelihood prescription. During the 3-month follow up, 32.6% of the participants had a composite event. Beta-blocker use was associated with reduced composite outcome (adjusted OR 0.51, 95% CI 0.26–0.98), adjusting for age, sex, NYHA classes, and comorbidities. In this study, we found a low rate of beta-blocker prescription, with only around half of the participants being prescribed beta-blockers. Beta-blocker use was associated with reduced adverse events. Further studies are needed to examine the reasons for under-prescription of beta-blockers, and to evaluate the long-term benefits of beta-blockers in elderly patients with heart failure.