Future perspectives of beta-blockers in chronic heart failure

Hiroshi Okamoto, Hiroyuki Tsutsui, Akira Kitabatake

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

The efficacy of beta-blockers for improving the survival rate of patients with chronic heart failure has been confirmed by results deriving from a series of randomized controlled trials (RCTs) such as MERIT-HF, CIBIS-II, and COPERNICUS. Thus, treatment guidelines recommend that beta-blockers should be used in all patients with heart failure resulting from left ventricular systolic dysfunction who can tolerate with beta-blockers. Despite these guidelines, actual rates of beta-blocker prescription has been lower than expected, and when used, beta-blockers are generally prescribed in doses lower than what has been shown to reduce morbidity and mortality in RCTs. In the MUCHA trial conducted in Japan, the beta-blocker carvedilol decreased the cardiovascular risk for hospitalization in a dose-dependent manner. The 5 mg/day dose achieved a remarkable reduction that was nearly as great as the 20 mg/day dose. Whether this low-dose therapy was sufficient was not fully investigated by the MUCHA trial. Moreover, there is an ethnic difference in the effective dose between patients in Japan and Western countries, which may depend on a difference in beta1-receptor sensitivity. J-CHF trial may suggest that low doses of carvedilol under 2.5 mg/day have a beneficial effect. This trial is a randomized multi-center parallel group dose-comparison study, and with sub-studies such as an analysis of genetic polymorphisms on voluntary participation. This trial may serve as a tailored approach for Japanese physicians in the clinical management of heart failure.

Original languageEnglish
Pages (from-to)921-926
Number of pages6
JournalNippon rinsho. Japanese journal of clinical medicine
Volume64
Issue number5
Publication statusPublished - Jan 1 2006
Externally publishedYes

Fingerprint

Heart Failure
Japan
Randomized Controlled Trials
Guidelines
Left Ventricular Dysfunction
Genetic Polymorphisms
Prescriptions
Hospitalization
Survival Rate
Morbidity
Physicians
Mortality
Therapeutics
carvedilol
high fluorescent intermediate II

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Future perspectives of beta-blockers in chronic heart failure. / Okamoto, Hiroshi; Tsutsui, Hiroyuki; Kitabatake, Akira.

In: Nippon rinsho. Japanese journal of clinical medicine, Vol. 64, No. 5, 01.01.2006, p. 921-926.

Research output: Contribution to journalReview article

@article{8699cf1e44d640e1a18dd79e8971934c,
title = "Future perspectives of beta-blockers in chronic heart failure",
abstract = "The efficacy of beta-blockers for improving the survival rate of patients with chronic heart failure has been confirmed by results deriving from a series of randomized controlled trials (RCTs) such as MERIT-HF, CIBIS-II, and COPERNICUS. Thus, treatment guidelines recommend that beta-blockers should be used in all patients with heart failure resulting from left ventricular systolic dysfunction who can tolerate with beta-blockers. Despite these guidelines, actual rates of beta-blocker prescription has been lower than expected, and when used, beta-blockers are generally prescribed in doses lower than what has been shown to reduce morbidity and mortality in RCTs. In the MUCHA trial conducted in Japan, the beta-blocker carvedilol decreased the cardiovascular risk for hospitalization in a dose-dependent manner. The 5 mg/day dose achieved a remarkable reduction that was nearly as great as the 20 mg/day dose. Whether this low-dose therapy was sufficient was not fully investigated by the MUCHA trial. Moreover, there is an ethnic difference in the effective dose between patients in Japan and Western countries, which may depend on a difference in beta1-receptor sensitivity. J-CHF trial may suggest that low doses of carvedilol under 2.5 mg/day have a beneficial effect. This trial is a randomized multi-center parallel group dose-comparison study, and with sub-studies such as an analysis of genetic polymorphisms on voluntary participation. This trial may serve as a tailored approach for Japanese physicians in the clinical management of heart failure.",
author = "Hiroshi Okamoto and Hiroyuki Tsutsui and Akira Kitabatake",
year = "2006",
month = "1",
day = "1",
language = "English",
volume = "64",
pages = "921--926",
journal = "Astrophysical Journal",
issn = "0004-637X",
publisher = "IOP Publishing Ltd.",
number = "5",

}

TY - JOUR

T1 - Future perspectives of beta-blockers in chronic heart failure

AU - Okamoto, Hiroshi

AU - Tsutsui, Hiroyuki

AU - Kitabatake, Akira

PY - 2006/1/1

Y1 - 2006/1/1

N2 - The efficacy of beta-blockers for improving the survival rate of patients with chronic heart failure has been confirmed by results deriving from a series of randomized controlled trials (RCTs) such as MERIT-HF, CIBIS-II, and COPERNICUS. Thus, treatment guidelines recommend that beta-blockers should be used in all patients with heart failure resulting from left ventricular systolic dysfunction who can tolerate with beta-blockers. Despite these guidelines, actual rates of beta-blocker prescription has been lower than expected, and when used, beta-blockers are generally prescribed in doses lower than what has been shown to reduce morbidity and mortality in RCTs. In the MUCHA trial conducted in Japan, the beta-blocker carvedilol decreased the cardiovascular risk for hospitalization in a dose-dependent manner. The 5 mg/day dose achieved a remarkable reduction that was nearly as great as the 20 mg/day dose. Whether this low-dose therapy was sufficient was not fully investigated by the MUCHA trial. Moreover, there is an ethnic difference in the effective dose between patients in Japan and Western countries, which may depend on a difference in beta1-receptor sensitivity. J-CHF trial may suggest that low doses of carvedilol under 2.5 mg/day have a beneficial effect. This trial is a randomized multi-center parallel group dose-comparison study, and with sub-studies such as an analysis of genetic polymorphisms on voluntary participation. This trial may serve as a tailored approach for Japanese physicians in the clinical management of heart failure.

AB - The efficacy of beta-blockers for improving the survival rate of patients with chronic heart failure has been confirmed by results deriving from a series of randomized controlled trials (RCTs) such as MERIT-HF, CIBIS-II, and COPERNICUS. Thus, treatment guidelines recommend that beta-blockers should be used in all patients with heart failure resulting from left ventricular systolic dysfunction who can tolerate with beta-blockers. Despite these guidelines, actual rates of beta-blocker prescription has been lower than expected, and when used, beta-blockers are generally prescribed in doses lower than what has been shown to reduce morbidity and mortality in RCTs. In the MUCHA trial conducted in Japan, the beta-blocker carvedilol decreased the cardiovascular risk for hospitalization in a dose-dependent manner. The 5 mg/day dose achieved a remarkable reduction that was nearly as great as the 20 mg/day dose. Whether this low-dose therapy was sufficient was not fully investigated by the MUCHA trial. Moreover, there is an ethnic difference in the effective dose between patients in Japan and Western countries, which may depend on a difference in beta1-receptor sensitivity. J-CHF trial may suggest that low doses of carvedilol under 2.5 mg/day have a beneficial effect. This trial is a randomized multi-center parallel group dose-comparison study, and with sub-studies such as an analysis of genetic polymorphisms on voluntary participation. This trial may serve as a tailored approach for Japanese physicians in the clinical management of heart failure.

UR - http://www.scopus.com/inward/record.url?scp=33745024136&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745024136&partnerID=8YFLogxK

M3 - Review article

C2 - 16689375

AN - SCOPUS:33745024136

VL - 64

SP - 921

EP - 926

JO - Astrophysical Journal

JF - Astrophysical Journal

SN - 0004-637X

IS - 5

ER -