Do All Beta Blockers provide the Same Magnitude of Clinically Convincing Mortality Benefits in Chronic Heart Failure Patients? : A Literature Review

Introduction: Chronic Heart Failure is characterized as a disorder arising from a complex interaction between impaired ventricular performance and neurohormonal activation. Beta Blockers are considered an integral component of therapy for chronic heart failure patients. Clinical trials have been conducted to determine the mortality benefits of these agents in Chronic Heart Failure patients.  The aim of this literature review is to ascertain whether all beta-blockers possess the evidence that demonstrates their mortality benefits in Chronic Heart Failure patients. 

Methodology: A literature search was conducted via Google Scholar. The keywords: Beta Blockers, mortality, and Heart Failure were employed as search terms. The search was limited to studies conducted between January 1990 and December 2017 and published in the English Language. Randomized trials, meta-analysis and systematic reviews were filtered. 

Results and discussion: The search yielded a total of Two Hundred and Fourteen Thousand (214,000) results. Studies with inconclusive findings, those conducted in the setting of Acute Heart Failure and trials lacking mortality benefits were not included in the final review. A total of five studies were considered in the final analysis due to the overwhelming mortality benefits in their findings. These studies used mainly carvedilol, bisoprolol and metoprolol succinate as therapeutic interventions. 

Conclusion: This review suggests that, not all beta-blockers provide the same magnitude of clinically convincing mortality benefits in Chronic Heart Failure patients. Only Bisoprolol, Carvedilol and Metoprolol Succinate possess such scientific evidence, hence they are considered evidence-based beta-blockers.