Table 3.
Baseline Patient Characteristics by Beta-Blocker Dosing Through 12-month Follow-up
| Stable Sub-target or Not Treated (n=1684) | Stable Target (n=476) | Medication Initiation/Dose Increase (n=256) | Medication Discontinuation/Dose Decrease (n=172) | P Value | |
|---|---|---|---|---|---|
| Age (years) | 69 (61–76) | 65 (56–73) | 63 (56–72) | 67 (59–75) | <0.001 |
| Female | 508 (30.2) | 125 (26.3) | 80 (31.3) | 42 (24.4) | 0.159 |
| Race | <0.001 | ||||
| White | 1334 (79.2) | 314 (66.0) | 175 (68.4) | 130 (75.6) | |
| Black/ African American | 205 (12.2) | 118 (24.8) | 56 (21.9) | 31 (18.0) | |
| Other | 145 (8.6) | 44 (9.2) | 25 (9.8) | 11 (6.4) | |
| Hispanic ethnicity | 369 (21.9) | 54 (11.3) | 38 (14.8) | 13 (7.6) | <0.001 |
| Ejection fraction (%) | 30 (25-36) | 30 (23-35) | 30 (22-35) | 28 (22-33) | 0.001 |
| NYHA class | 0.245 | ||||
| I | 161 (9.7) | 59 (12.6) | 32 (13.2) | 16 (9.5) | |
| II | 989 (59.8) | 268 (57.3) | 140 (57.6) | 89 (52.7) | |
| III | 466 (28.2) | 134 (28.6) | 68 (28.0) | 60 (35.5) | |
| IV | 39 (2.4) | 7 (1.5) | 3 (1.2) | 4 (2.4) | |
| KCCQ-os Score | 68 (48-85) | 71 (49-87) | 69 (48-84) | 55 (39-76) | <0.001 |
| Vital sign and laboratory findings | |||||
| Systolic blood pressure (mmHg) | 120 (110-130) | 122 (112-136) | 120 (110-132) | 116 (105-130) | <0.001 |
| Diastolic blood pressure (mmHg) | 72 (65-80) | 74 (67-80) | 73 (68-80) | 70 (62-80) | 0.008 |
| Heart rate (bpm) | 72 (65-80) | 72 (65-80) | 76 (68-87) | 74 (64-82) | <0.001 |
| Body mass index (kg/m2) | 28.9 (25.3-33.3) | 31.5 (27.6-36.5) | 30.2 (25.6-35.1) | 29.3 (25.5-33.9) | <0.001 |
| Hemoglobin (g/dL) * | 13.3 (12.1-14.5) | 13.3 (12.2-14.4) | 13.3 (11.9-14.4) | 13.0 (11.4-14.3) | 0.272 |
| Serum sodium (mmol/L) † | 139 (137-141) | 140 (138-142) | 139 (137-141) | 139 (137-142) | 0.435 |
| BUN (mg/dL) ‡ | 20 (15-27) | 20 (15-27) | 19 (15-25) | 22 (16-28) | 0.227 |
| eGFR (mL/min/1.73m2) § | 0.009 | ||||
| <30 | 46 (4.4) | 20 (6.5) | 5 (2.8) | 10 (7.5) | |
| 30-44 | 135 (12.9) | 40 (13.1) | 21 (11.8) | 19 (14.3) | |
| 45-59 | 242 (23.2) | 76 (24.8) | 32 (18.0) | 45 (33.8) | |
| ≥60 | 620 (59.4) | 170 (55.6) | 120 (67.4) | 59 (44.4) | |
| NT-proBNP (pg/mL) ‖ | 1880 (811-4534) | 1045 (638-3020) | 2016 (801-5143) | 1137 (571-4135) | 0.141 |
| Hemoglobin A1c (%) # | 6.4 (5.8-7.4) | 6.9 (6.1-8.6) | 6.5 (5.9-7.9) | 6.3 (5.7-7.0) | 0.005 |
| Medical history | |||||
| HF hospitalization within 12 months prior to enrollment | 588 (34.9) | 137 (28.8) | 122 (47.7) | 88 (51.2) | <0.001 |
| Coronary artery disease | 1077 (64.0) | 274 (57.6) | 149 (58.2) | 125 (72.7) | 0.001 |
| Hypertension | 1388 (82.4) | 403 (84.7) | 203 (79.3) | 148 (86.0) | 0.187 |
| Hyperlipidemia | 1334 (79.2) | 363 (76.3) | 174 (68.0) | 137 (79.7) | <0.001 |
| Diabetes mellitus | 644 (38.2) | 228 (47.9) | 108 (42.2) | 74 (43.0) | 0.002 |
| Atrial fibrillation | 588 (34.9) | 155 (32.6) | 89 (34.8) | 82 (47.7) | 0.004 |
| Chronic renal insufficiency | 290 (17.2) | 104 (21.8) | 40 (15.6) | 44 (25.6) | 0.006 |
| Asthma/ COPD | 539 (32.0) | 127 (26.7) | 79 (30.9) | 56 (32.6) | 0.161 |
| History of ventricular tachycardia/ fibrillation | 295 (17.5) | 109 (22.9) | 32 (12.5) | 46 (26.7) | <0.001 |
| Depression | 436 (25.9) | 111 (23.3) | 65 (25.4) | 43 (25.0) | 0.727 |
| Active cigarette smoking | 343 (20.4) | 80 (16.8) | 54 (21.1) | 35 (20.3) | 0.343 |
| Heart failure device therapy | |||||
| Implantable cardioverter-defibrillator | 672 (39.9) | 254 (53.4) | 78 (30.5) | 88 (51.2) | <0.001 |
| Cardiac resynchronization therapy | 101 (6.0) | 37 (7.8) | 18 (7.0) | 14 (8.1) | 0.423 |
| Social and economic characteristics | |||||
| Insurance status | <0.001 | ||||
| Private Insurance/ Managed care (HMO, PPO) | 423 (25.1) | 134 (28.2) | 86 (33.6) | 37 (21.5) | |
| Medicare | 1033 (61.3) | 259 (54.4) | 116 (45.3) | 107 (62.2) | |
| Medicaid | 139 (8.3) | 45 (9.5) | 33 (12.9) | 20 (11.6) | |
| Other | 69 (4.1) | 24 (5.0) | 14 (5.5) | 6 (3.5) | |
| Uninsured | 20 (1.2) | 14 (2.9) | 7 (2.7) | 2 (1.2) | |
| Highest level of education | 0.542 | ||||
| Less than high school | 224 (13.3) | 53 (11.1) | 30 (11.7) | 19 (11.0) | |
| High school/ GED | 552 (32.8) | 172 (36.1) | 85 (33.2) | 60 (34.9) | |
| Some college | 528 (31.4) | 155 (32.6) | 82 (32.0) | 50 (29.1) | |
| Four-year college (Bachelor’s Degree) | 211 (12.5) | 62 (13.0) | 33 (12.9) | 19 (11.0) | |
| Graduate or other professional degree | 169 (10.0) | 34 (7.1) | 26 (10.2) | 24 (14.0) | |
| Total household income | 0.080 | ||||
| <$25,000 | 534 (31.7) | 130 (27.3) | 87 (34.0) | 50 (29.1) | |
| $25,000-$49,999 | 321 (19.1) | 109 (22.9) | 37 (14.5) | 36 (20.9) | |
| $50,000-$74,999 | 191 (11.3) | 55 (11.6) | 35 (13.7) | 15 (8.7) | |
| $75,000-$99,999 | 108 (6.4) | 26 (5.5 ) | 14 (5.5) | 12 (7.0) | |
| $100,000-$149,999 | 92 (5.5) | 21 (4.4) | 13 (5.1) | 12 (7.0) | |
| ≥$150,000 | 42 (2.5) | 7 (1.5) | 12 (4.7) | 1 (0.6) | |
| Prefer not to answer | 396 (23.5) | 128 (26.9) | 58 (22.7) | 46 (26.7) | |
| Employment status | <0.001 | ||||
| Full-time employee (≥35 hours/week) | 218 (12.9) | 70 (14.7) | 58 (22.7) | 18 (10.5) | |
| Part-time employee (<35 hours/week) | 115 (6.8) | 39 (8.2) | 18 (7.0) | 10 (5.8) | |
| Disability for medical reasons | 380 (22.6) | 150 (31.5) | 64 (25.0) | 56 (32.6) | |
| Not employed for other reasons (e.g., retired, student, unemployed) | 971 (57.7) | 217 (45.6) | 116 (45.3) | 88 (51.2) |
Data represent median (quartile 1 – quartile 3) or n (%).
There were 916, 249, 146, and 119 patients with available data for stable sub-target, stable target, medication initiation/dose increase, and medication discontinuation/dose decrease, respectively.
There were 1175, 335, 190, and 147 patients with available data for stable sub-target, stable target, medication initiation/dose increase, and medication discontinuation/dose decrease, respectively.
There were 1135, 323, 192, and 142 patients with available data for stable sub-target, stable target, medication initiation/dose increase, and medication discontinuation/dose decrease, respectively.
There were 1043, 306, 178, and 133 patients with available data for stable sub-target, stable target, medication initiation/dose increase, and medication discontinuation/dose decrease, respectively.
There were 159, 52, 43, and 23 patients with available data for stable sub-target, stable target, medication initiation/dose increase, and medication discontinuation/dose decrease, respectively.
There were 362, 97, 51, and 33 patients with available data for stable sub-target, stable target, medication initiation/dose increase, and medication discontinuation/dose decrease, respectively.
BMI, body mass index; bpm, beats per minute; BUN, blood urea nitrogen; COPD, chronic obstructive pulmonary disease; eGFR, estimated glomerular filtration rate; GED, general equivalency diploma; HF, heart failure; HMO, health maintenance organization; KCCQ-os, Kansas City Cardiomyopathy Questionnaire overall summary score; NT-proBNP, N-terminal pro-B-type natriuretic peptide; NYHA, New York Heart Association; PPO, preferred provider organization.