Skip to main content
Log in

Beta-blockade as First-line Therapy in the Elderly Heart Failure Patient—the Proper Approach or Asking for Trouble?

Editorial to: “The clinical effects of initial 6 months monotherapy with bisoprolol versus enalapril in the treatment of patients with mild to moderate chronic heart failure. Data from the CIBIS III trial” by D. Dobre et al.

  • Editorial
  • Published:
Cardiovascular Drugs and Therapy Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Swedberg K, Cleland J, Dargie H, et al. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005). Eur Heart J 2005;26:1115–40.

    Article  PubMed  CAS  Google Scholar 

  2. Packer M, Bristow MR, Cohn JN, et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group. N Engl J Med 1996;334:1349–55.

    Article  PubMed  CAS  Google Scholar 

  3. CIBIS II Investigators and Committees. The Cardiac Insufficiency Bisoprolol Study II (CIBIS II): a randomised trial. Lancet 1999;353:9–13.

    Article  Google Scholar 

  4. Hjalmarson A, Goldstein S, Fagerberg B, et al. Effect of metoprolol CR/XL in chronic heart failure: metoprolol CR/XL randomized intervention trial in congestive heart failure (MERIT-HF). Lancet 1999;353:2001–7.

    Article  Google Scholar 

  5. Packer M, Coats AJS, Fowler MB, Carvedilol Prospective Randomized Cumulative Survival Study Group (COPERNICUS), et al. Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med 2001;344:1651–8.

    Article  PubMed  CAS  Google Scholar 

  6. Flather MD, Shibata MC, Coats AJ, et al. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J 2005;26:215–25.

    Article  PubMed  CAS  Google Scholar 

  7. Garg R, Yusuf S. Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. Collaborative Group on ACE Inhibitor Trials. JAMA 1995;273:1450–6.

    Article  PubMed  CAS  Google Scholar 

  8. Francis GS, Benedict C, Johnston DE, et al. Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure: a substudy of the Studies Of Left Ventricular Dysfunction (SOLVD). Circulation 1990;82:1724–9.

    PubMed  CAS  Google Scholar 

  9. Esler M, Jennings G, Korner P, et al. Assessment of human sympathetic nervous system activity from measurements of norepinephrine turnover. Hypertension 1988;11:3–20.

    PubMed  CAS  Google Scholar 

  10. Mann DL, Kent RL, Parsons B, Cooper G. Adrenergic effects on the biology of the adult mammalian cardiocyte. Circulation 1992;24:549–64.

    Google Scholar 

  11. Communal C, Singh K, Pimentel DR, Colucci WS. Norepinephrine stimulates apoptosis in adult rat ventricular myocytes by activation of beta-adrenergic pathway. Circulation 1998;98:1329–34.

    PubMed  CAS  Google Scholar 

  12. Remme WJ. Pharmacological modulation of cardiovascular remodelling: a guide to heart failure therapy. Cardiovasc Drugs Ther 2003;17:349–60.

    Article  PubMed  CAS  Google Scholar 

  13. Remme WJ, Riegger G, Hildebrandt P, on behalf of the CARMEN investigators, et al. The benefits of early combination treatment of carvedilol and an ACE-inhibitor in mild heart failure and left ventricular systolic dysfunction. The Carvedilol and Ace-inhibitor Remodelling Mild heart failure EvaluatioN trial (CARMEN). Cardiovasc Drugs Ther 2004;18:57–66.

    Article  PubMed  CAS  Google Scholar 

  14. Remme WJ, Cleland JG, Erhardt L, et al. Effect of carvedilol and metoprolol on the mode of death in patients with heart failure. Eur J Heart Fail 2007;9:1128–35.

    Article  PubMed  CAS  Google Scholar 

  15. Knight EL, Glynn RJ, McIntyre KM, Mogun H, Avorn J. Predictors of decreased renal function in patients with heart failure during angiotensin-converting enzyme inhibitor therapy: results from the studies of left ventricular dysfunction (SOLVD). Am Heart J 1999;138:849–55.

    Article  PubMed  CAS  Google Scholar 

  16. Sliwa K, Norton GR, Kone N, et al. Impact of initiating carvedilol before angiotensin converting enzyme inhibitor therapy on cardiac function in newly diagnosed heart failure. J Am Coll Cardiol 2004;44:1825–30.

    Article  PubMed  CAS  Google Scholar 

  17. Willenheimer R, van Veldhuisen DJ, Silke B, on behalf of the CIBIS III investigators, et al. Effect on survival and hospitalization of initiating treatment for chronic heart failure with bisoprolol followed by enalapril, as compared with the opposite sequence. Results of the Randomized Cardiac Insufficiency Bisoprolol study (CIBIS) III. Circulation 2005;112:2426–35.

    Article  PubMed  CAS  Google Scholar 

  18. Dobre D, Van Veldhuisen DJ, Goulder MA, Krum H, Willenheimer R. Clinical effects of initial 6 months therapy with bisoprolol versus enalapril in the treatment of patients with mild to moderate chronic heart failure. Data from the CIBIS III trial. Cardiovasc Drugs Ther. 2008;22 (this issue).

  19. Kohno T, Yoshikawa T, Yoshizawa A, et al. Carvedilol exerts more potent antiadrenergics effect than metoprolol in heart failure. Cardiovasc Drugs Ther 2005;19:347–55.

    Article  PubMed  CAS  Google Scholar 

  20. Poole-Wilson PA, Swedberg K, Cleland JGF, et al. Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure. Results of the Carvedilol Or Metoprolol European Trial (COMET). Lancet 2003;362:7–13.

    Article  PubMed  CAS  Google Scholar 

  21. Remme WJ, Torp-Pedersen C, Cleland JGF, Poole-Wilson PA, Metra M, Komajda M, et al. Carvedilol protects better against vascular events than metoprolol in heart failure: results from COMET. J Am Coll Cardiol 2007;49:963–71.

    Article  PubMed  CAS  Google Scholar 

  22. Di Lenarda A, Remme WJ, Charlesworth A, for the COMET investigators, et al. Exchange of b-blockers in heart failure patients. Experiences from the poststudy phase of COMET (the Carvediolol Or Metoprolol European Trial). Eur J Heart Fail 2005;7:640–9.

    Article  PubMed  CAS  Google Scholar 

  23. Busby MJ, Shefrin EA, Fleg JL. Prevalence and long-term significance of exercise-induced frequent or repetitive ventricular ectopic beats in apparently healthy volunteers. J Am Coll Cardiol 1989;14:1659–65.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Willem J. Remme.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Remme, W.J. Beta-blockade as First-line Therapy in the Elderly Heart Failure Patient—the Proper Approach or Asking for Trouble?. Cardiovasc Drugs Ther 22, 347–350 (2008). https://doi.org/10.1007/s10557-008-6126-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10557-008-6126-7

Navigation