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European Journal of Heart Failure 2005 7(4):604-611; doi:10.1016/j.ejheart.2004.03.008
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© 2005 European Society of Cardiology

Effects of bisoprolol treatment for chronic heart failure initiated and followed up by primary care physicians

A. Schuchert* and On behalf of the BISEX Investigators (Appendix A)

Medical Clinic III, University-Hospital Hamburg-Eppendorf Martinistr. 52, D-20246 Hamburg, Germany

* Tel.: +49-40-428035304; Fax: +49-40-428035766. E-mail address: schuchert{at}uke.uni-hamburg.de


  Abstract

Primary care physicians prescribe beta-blockers for chronic heart failure infrequently. The aims of the study were to assess the effects of beta-blocker treatment in out-clinic patients with regard to NYHA class and frequency of adverse events. Beta-blocker treatment was initiated and followed up by primary care physicians.

Methods: Chronic heart failure patients already treated with ACE-inhibitors and diuretics were included. The 24-week follow-up consisted of a titration phase followed by a maintenance phase. The patients received the beta-blocker bisoprolol with an initial dose of 1.25 mg and a maximal dose of 10 mg.

Results: NYHA class II, III and IV had 174, 146, and one patient, respectively. Treatment duration lasted 189±73 days with a maximal bisoprolol dose of 7.2±3.2 mg. Sixty-one percent of the patients tolerated at least 7.5 mg bisoprolol. The NYHA class improved from 2.4±0.5 at baseline to 1.8±0.6 at week 24 (P<0.001). At final assessment, 74% of the patients showed an improvement. The number of permanent treatment withdrawals was 57 (17%). Death occurred in six patients and hospitalisation in 38 patients.

Conclusions: Bisoprolol treatment in patients with chronic heart failure was effectively and safely carried out by primary care physicians.

Key Words: Chronic heart failure • Adrenergic beta-antagonists • Bisoprolol • Heart rate • Blood pressure • NYHA class

Received September 12, 2003; Revised January 12, 2004; Accepted March 29, 2004


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