Prevention

Why?

• Beta-blockers improve symptoms ^a and reduce hospital admissions ^a (particularly for worsening heart failure) and mortality ^a
• Carvedilol increases ejection fraction more than metoprolol (on average by 4% at 15 months) without clearly reducing mortality or need for urgent transplant. ^d

Beta-blockers reduce death and improve symptoms

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
stable heart failure a	beta-blockers	placebo	death at 8 months	12%	32% (22% to 47%)	26 (18 to 38)
			hospitalised for worsening heart failure at 8 months	17%	41% (26% to 52%)	14 (11 to 23)
			improvement in NYHA class at 8 months	21%	-32% (-74% to -1%)	3 (2 to 4)

Beta-blockers reduce hospital admissions

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
stable heart failure a	bisoprolol	placebo	admitted to hospital at 1.3 years	12%	15% (6% to 23%)	18 (11 to 49)