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Clinical and economic aspects of the use of nebivolol in the treatment of elderly patients with heart failure

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      Heart failure is a common and disabling condition with morbidity and mortality that increase dramatically with advancing age. Large observational studies, retrospective subgroup analyses and meta-analyses of clinical trials in systolic heart failure, and recently published randomized studies have provided data supporting the use of beta-blockers as a baseline therapy in heart failure in the elderly. Despite the available evidence about beta-blockers, this therapy is still less frequently used in elderly compared to younger patients. Nebivolol is a third-generation cardioselective beta-blocker with L-arginine/nitric oxide-induced vasodilatory properties, approved in Europe and several other countries for the treatment of essential hypertension, and in Europe for the treatment of stable, mild, or moderate chronic heart failure, in addition to standard therapies in elderly patients aged 70 years old or older. The effects of nebivolol on left ventricular function in elderly patients with chronic heart failure (ENECA) and the study of effects of nebivolol intervention on outcomes and rehospitalization in seniors with heart failure (SENIORS) have been specifically aimed to assess the efficacy of beta-blockade in elderly heart failure patients. The results of these two trials demonstrate that nebivolol is well tolerated and effective in reducing mortality and morbidity in older patients, and that the beneficial clinical effect is present also in patients with mildly reduced ejection fraction. Moreover, nebivolol appears to be significantly cost-effective when prescribed in these patients. However, further targeted studies are needed to better define the efficacy as well as safety profile in frail and older patients with comorbid diseases.

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      [1 ] Heart Failure Unit, Division of Cardiology, INRCA Institute of Care and Research for Elderly, Rome, Italy;
      [2 ] Heart Failure Clinic, Division of Cardiology/CCU, San Camillo Hospital, Rome, Italy
      Author notes
      Correspondence: Donatella Del Sindaco, Via G. Livraghi 1, 00152, Rome, Italy, Tel +390 630 3421, Fax +390 630 3421, Email ddelsindaco@
      Clin Interv Aging
      Clinical Interventions in Aging
      Dove Medical Press
      03 December 2010
      : 5
      : 381-393
      © 2010 Del Sindaco et al, publisher and licensee Dove Medical Press Ltd.

      This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.


      Health & Social care

      prognosis, older, beta-blockers, left ventricular dysfunction, therapy


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