Background: Medical management of Heart failure with preserved ejection fraction (HFpEF) remains uncertain, especially beta blockers (BBs) had various outcomes in studies. The objective of the present study is to review the efficacy and prognostic role of BBs in patients with HFpEF. Methods: A total of 58 articles were chosen for this narrative review from sources including web of science, PUBMED and Google Scholar. Results: Patients with HFpEF are more prevalent in female. The average age of patients is usually 70-80 years. The most important risk factors for this condition include advanced age, female gender, hypertension (HTN), diabetes mellitus (DM), coronary artery disease (CAD), and atrial fibrillation (AF). Despite a lack of evidence or indication, BBs are still extensively prescribed in HFpEF. In patients with HFpEF, BBs reduce blood pressure, left ventricular hypertrophy, and diastolic dysfunction by slowing heart rate and myocardial oxygen demand. BBs reduce blood pressure, but despite this, they do not improve the quality of life, cardiovascular events, and all-cause mortality. BBs may even be associated with an increased risk of HF hospitalization. In some studies, Carvedilol and Nebivolol were associated with improvement of functional capacity, NT Pro-BNP levels, and survival. Overally, using the BBs, recommended for patients of HFPEF with atrial fibrillation, hypertension, and coronary artery disease. Conclusion: BBs does not have a beneficial effect on quality of life and survival, and is also linked to a higher risk of HF-related hospitalizations. The use of BBs is not recommended for the treatment of HFpEF.
| Published in | Science Journal of Clinical Medicine (Volume 15, Issue 3) |
| DOI | 10.11648/j.sjcm.20261503.12 |
| Page(s) | 43-57 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2026. Published by Science Publishing Group |
Heart Failure with Preserved Ejection Fraction, Beta Blocker, Efficacy, Prognosis, Review
Author/year | country | Sample | Male (%) | Age (Years) | BMI | RF (%) | Study type | NYHA class | Echo findings | Key finding |
|---|---|---|---|---|---|---|---|---|---|---|
Arnold SV et al/2023 [1] | USA | 435,897 patients | 52.6 | 76.1 ± 7.8 | 29.5 ± 6.0 | DM:30.3 CVA:15.6 AF/AFl:45 CAD:70 CKD:9.5 | RCT | _ | LVEF: 56.8 ± 9.6 | lack of survival benefit and a higher risk of HF hospitalization associated with the use of BBs. |
Palau P et al /2021 [2] | Spain | 52 patients | 40.4 | 72.6 ± 13.1 | 31.1 ± 4.7 | HTN: 88.5 DM:40.4 IHD:23.1 CVA:1.9 AF:38.5 COPD:11.5 | RCT | III/IV: 34.6 | LVEF: 64.7 ± 7.1 LAVI, mL/m2: 39.8 ± 13.7 LVMI, g/m2: 108.0 ± 31.6 E/e′: 14.6 | BBs withdrawal resulted in a short-term improvement of maximal functional capacity and chronotropic incompetence. |
Matsumoto S et al/2025 [3] | UK | 16951 patients | 50.2 | 71.5±8.7 | _ | AF: 48.7 | Observational Study | _ | LVEF: 56.2±8.6 | There was no suggestion that BBs use was associated with worse HF outcomes in HFmrEF/HFpEF. |
Palau P et al/2024 [4] | Spain | 52 patients | 40 | 74.7 | 31.1 | HTN:44.2 DM:20.1 IHD:11.5 AF:19.2 | RCT | III/IV | LVEDV, mL/m2: 44.7 LVEF: 64.7 LAVI, mL/m2: 39.8 LVMI, g/m2: 108 E/e’: 14.7 | Lower iLVESV could identify patients in whom BBs withdrawal was associated with a greater short-term improvement in maximal functional capacity. |
Peikert A et al/2024 [5] | USA | 3,131 patients | 56.1 | 71.7 ± 9.6 | 29.8 ± 6.1 | AF:56.7 CVA:9.5 DM:44.8 MI: 26.2 HTN:88.7 CAD:51.4 | RCT | I: 0.0 II: 75.3 III: 24.4 IV: 0.3 | LVEF,%:54.2 ± 8.8 | BBs use was not associated with a higher risk of worsening HF or CV death and QOL. |
Fu EL et al/2020 [6] | Netherlands | 3775 patients | 64.1 | 80.2 | 26.8 | AF:61.4 COPD:16.5 DM:39.3 HTN:75.4 IHD:74.5 CVA:19.3 | Observational Study | I:2.03 II:19.1 III:39.2 IV:8.8 | _ | In patients with HFpEF in sinus rhythm, BBs use was not related to one-year mortality or mortality plus HF readmission. |
Yang Y et al/2020 [7] | China | 78 patients | 44.9 | 76 | _ | HTN:66.5 DM:29.8 AMI:9.4 CVA:25.7 | cohort study | _ | LAD (mm):44 (40–48) LVEDD (mm):47 (43–51) PAP (mmHg):42.2 ± 12.2 | In HFpEF patients with AF, BBs is associated with significantly lower all-cause mortality, but may increase the risk of HF rehospitalization. |
Abdel Jawad M et al/2025 [8] | USA | 1726 patients | 50.1 | 71.6 | 33.8 | MI: 20.4 PAD:11.8 CVA: 8.9 AF:42.3 OAD:16.7 DM: 44.7 HTN:89.9 | RCT | _ | EF:57.7% HR: 76 bpm | BBs use was not associated with significantly different concurrent HF–specific health status or modification of the health status. |
Tsujimoto T ETAL/2018 [9] | Japan | 6834 patients | 48.3 | 68.5 | 32.1 | DM:32.4 HTN:91.4 MI:12.9 CVA:7.7 AF:35.2 COPD:11.6 | RCT | I/II:67.04 III/IV:32.96 | -------- | NYHA functional classification was not significantly different between those on and not on BBs. |
Silverman DN et al/2019 [10] | USA | 1394 patients | 51.8 | 71.3 | 34 | MI:20.3 HTN:90.1 AF:42.2 | RCT | III/IV | EF:58.17 EF ≥50%:88.9 EF ≥60%:48.5 | BBs use in the TOPCAT trial cohort was associated with a higher risk for incident HF hospitalization, without an associated change in CVD mortality. |
Yum B et al/2019 [11] | USA | 207 patients | 44 | 77 | _ | HTN: 83 CAD: 64 DM: 50 AF/AFl:44 COPD: 43 CKD: 42 CVA: 18 | Observational Study | _ | _ | BBs can worsen function in patients with geriatric conditions and can increase their risk for adverse drug reactions. |
Farasat SM et al/2010 [12] | USA | 66 patients | 32 | 71 ± 13 | _ | _ | Comparative Study | _ | _ | BBs may be associated with a higher risk of HF rehospitalization in women with HFpEF. |
Patel K et al/2014 [13] | USA | 2553 patients | 35.5 | 81.2±8 | _ | CAD:40.3 HTN:72.6 DM:36.9 AF:33.4 COPD:24.7 CKD:6.1 | RCT | _ | _ | BBs has not independent associations with long-term outcomes, regardless of evidence class or daily dosages used. |
Meyer M et al/2021 [14] | USA | 14434 patients | 48.6 | 79.3 | BMI ≥30 kg/m2: 20.3 | HTN:70.6 DM:27.6 PAD:9.5 AF:61.3 COPD:16.4 | RCT | I:8.7 II:26.8 III:19.7 IV:1.6 | _ | No associations between BBs and outcomes. The adverse BBs effects should be considered in a patient group that is prone to polypharmacy. |
Lund LH et al/2014 [15] | Sweden | 5496 patients | 54 | 78 | _ | HTN:58 DM:25 MI:32 AF/AFl:52 | RCT | I:19 II:46 III:31 IV:4 | LVEF%: 40-49: 44 ≥50: 58 | BBs was associated with lower all-cause mortality but not with combined all-cause mortality or HFH. |
Harada E et al/2022 [16] | Japan | 721 patients | 25.5 | 81.8± 8.9 | 21.49 | AF: 18.8 HTN: 80.1 DM: 39.6 DLP: 33.3 | RCT | _ | LVEF:67.6% E/e′:17.6 E/A:0.76 LVDd,:41.4mm LVDv:28.9mm/m2 LAD:36.4mm RWT:0.527 | BBs were associated with high-plasma BNP levels in conjunction with the structural and functional alterations of the heart differently in men and women with HFpEF in SR but not in AF. |
Maldonado-Martín S et al/2020 [17] | Spain | 59 patients | 29.7 | 70.7±6.8 | 30.9±4.7 | HTN:92.2 DM:18.8 | RCT | I: 0 II: 67.2 III: 32.8 | _ | BBs may favorably alter the biological properties of the cardiac autonomic system regulation in elderly patients with HFpEF, such as HRpeak, HRresv, HRrecov, and Vo2 peak. |
Palau P et al/2020 [18] | Spain | 28 patients | 32.10 | 74.3 (68‐77) | _ | _ | RCT | _ | _ | BBs in HFpEF patients has not benefit, even less in those with documented chronotropic incompetence. |
Lam PH et al/2018 [19] | USA | 1370 patients | 34.17 | 76 | _ | HTN:80.1 CAD:44.6 MI:17.1 DM:43.9 AF:39 COPD:24.2 | RCT | _ | LVEF:58.6 | In patients with HFpEF and heart rate ≥70 beats/minute, high-dose BBs use was associated with a significantly lower risk of total mortality. |
Seko Y et al/2022 [20] | Japan | 388 patients | 51.1 | 87.1±12 | BMI ≤22 kg/m2: 59.27 | HTN:65.7 DM:30.4 AF:40.9 VT/VF:0.2 MI:10.5 | observational | _ | HFpEF (EF ≥50%):55.6 HFmrEF (EF 40–49%):44.3 | Starting both ACE-I/ARB and BBs were associated with a reduced risk of the composite of all-cause death or HFH. |
Kim SH et al/2019 [21] | Korea | 4045 patients | 42.6 | 71.4±13.4 | 23.6±3.8 | HTN:67.7 DM:35.9 IHD:38.4 CHF:39.2 AF:32.9 COPD:12.1 CKD:12.7 | cohort study | II:17.7 III:36.8 IV:45.4 | EF:53.6±9.1 LAD (mm):48.8±10.7 | BBs is associated with reduced all-cause death but not with reduced rehospitalization. |
Harada D et al/2020 [22] | Japan | 213 patient | 47.41 | 75.8 | 23.7 | HTN:90.6 DM:23.0 AF:23.9 COPD:7.9 | cohort study | _ | LVEF:65.3 LVEDD, mm:47.2 IVST, mm:10.63 PWT, mm:10.5 LVMI, g/m2:140.8 E/e′:11.1 | BBs were not associated with a reduction in the rate of cardiovascular events but it may have beneficial effects on HFpEF with preserved RV function. RV function may serve as an indicator in patients with HFpEF. |
Yamamoto K et al/2014 [23] | Japan | 245 patients | 57.9 | 72 ±10.7 | 24.1±4.2 | AF:48.1 HTN:80.4 IHD:26.1 DM:30.6 DLP:40.8 | RCT | I:18.3 II:72.2 III:7.7 IV:1.6 | LVEF:62±10.2 LVEDD (mm):50±7.7 LVMI (g/m2) 7:63.2±24.8 PWT:0.4±0.1 | Carvedilol may exert greater reduction of the incidence of clinical outcomes in the patients with HFPEF and advanced rather than mild diastolic dysfunction. |
Uijl A et al/2024 [24] | sweden | 20980 patients | 48.20 | 79.0 [71.0–85.0] | 28.0 (6.2) | AF: 63.9 HTN: 74.5 COPD: 16.0 DM: 28.6 | cohort study | I-III | _ | The association with all-cause mortality and non-CV hospitalization was heterogeneous across clusters for BBs. It remains to be elucidated how heterogeneity in HFpEF could influence personalized medicine and future clinical trial. |
Conraads VM et al/2012 [25] | Belgium | 57 patients | 35 | 66.5 ± 9.8 | 30.3 ± 4.5 | HLP:56 HTN: 86 DM: 21 COPD: 16 | RCT | II/III | LVEF:61.9 ± 7.8 E/A ratio: 0.8 ± 0.18 E/e': 11.1±4.2 | 6 months treatment with Nebivolol did not improve exercise capacity. Its negative chronotropic effect may have contributed to this result. |
Tost J et al/2021 [26] | Spain | 2312 patients | 39.1 | 83 | _ | DM: 42.1 DLP: 49.7 CRD: 28.1 AF: 62.8 | cohort study | III-IV | LVEF: 60.2 | BBs were prescribed in 45.8% of patients. BBs were associated with worse results in some co-primary or secondary endpoints. |
Yamamoto K et al/2013 [27] | Japan | 120 patients | 57.5 | 73 ± 1 | 73 ± 10 | HTN: 80.0 IHD: 28.3 AF: 50.8 DM: 27.5 DLP: 35.8 | RCT | I:22 II:83 III:13 IV:2 | LVEF: 62 ± 10 LVMI (g/m2): 126 ± 44 LAD (mm): 44 ± 8 | Carvedilol did not improve the prognosis of HFPEF patients overall. |
Edelmann F et al/2016 [28] | Germany | 250 patients | 66 | 73.4 ± 6.0 | 29.5 ± 5.9 | HTN:90 CAD: 33 DM: 23 HLP: 66 AF: 10 COPD: 9 | RCT | I: 1 II: 76 III: 23 | LVEF:58.9± 8.8 | The tolerability of BBs was low. Titration delays and non-severe side effects more often occurred in HFpEF than HFrEF. |
Ahn MS et al/2020 [29] | Korea | 878 patients | 62.3 | 68.3±12.7 | 23.4±3.6 | HTN:56.1 DM: 32.3 IHD: 23.4 MI: 15.6 CKD: 11.1 COPD:11.3 | cohort study | II:12.7 III:42 IV:45.3 | LVEF:27.4±8 LVEDV, mL:158.9±68.7 LVESV, mL:115.6±56.3 LAD, mm:50.6±7.8 | BBs were not associated with clinical outcome. However, in HFpEF with AF, BBs reduced rehospitalization during the 6-month and 1-year follow-up. |
Kim YI et al/2024 [30] | Korea | 249 patients | 37.3 | 73.8±11.2 | 23.69±3.94 | HTN:75.9 DM:32.5 IHD:16.8 CKD:9.6 COPD:11.2 | cohort study | II:17.6 III:37.7 IV:44.5 | LVEF:58.5±6.5 LVEDVi (mL/m2):63.8±29.6 LVESVi (mL/m2):26.6±15.3 LAVI (mL/m2):69.3±33.6 | In HFpEF with AF, in patients with HR over 75 bpm at discharge, BBs was associated with a reduced 60-day rehospitalization rate. |
Dobre D et al/2007 [31] | Netherlands | 443 patients | 44.5 | 77.6 | _ | HTN: 49.4 MI: 36.1 DM: 28.7 AF: 44.5 COPD:28.4 | Cohort study | _ | _ | BBs were associated with a significant mortality reduction. |
Formiga F et al/2022 [32] | Spain | 531 patients | 39 | 78.9 | 30.3 | HTN: 93 DM:53 IHD:60 CKD:62 COPD:17 | observational study | _ | _ | In patients with HFpEF in sinus rhythm, BBs use was not related to one-year mortality or mortality plus HF readmission. |
El-Refai M et al/2013 [33] | USA | 741 patients | 39.4 | 71.3 ±12.3 | _ | AF: 29.8 DM: 46.4 HTN: 73.4 COPD:39.0 | Comparative Study | _ | LVEF: 57.2 ±5.4 | BBs exposure was associated with a similar protective effect in terms of time to death or HFH. |
van Veldhuisen DJ et al/2009 [34] | Netherlands | 380 patients | 49.2 | age ≥70 years | _ | CAD:77.1 MI: 32.4 HTN:77.7 HLP: 46.9 AF: 36.0 DM: 24.3 | RCT | I: 3.5 II: 62.5 III:32.2 IV: 1.9 | LVEF≥50% | The current study provides the first large-scale data for a potentially beneficial effect of BBs in HFpEF, and is the only one in elderly patients. |
Park K et al/2016 [35] | South Korea | 62 patients | _ | over 70 years of age | _ | _ | RCT | II or III | LVEF ≥40% | There was no difference between carvedilol and nebivolol for improving diastolic function of elderly HF patients. |
Smith DT et al/2010 [36] | USA | 534 patients | 84 | 67±11 | 29±5 | DM:29 MI: 60 | RCT | _ | LVEF: 62±9 | BBs is associated with a decreased risk of HFH in patients with diastolic dysfunction and stable CHD. |
Mittal N et al/2017 [37] | India | _ | _ | _ | _ | _ | RCT | _ | _ | Metoprolol succinate has some beneficial role in HFpEF including QoL parameters. |
Cleland JGF et al/2018 [38] | UK | 819 patients | 60.1 | 72.2 | 27 | MI: 61.1 DM: 25.1 | SRMA | III/IV | LVEF:46.5 | LVEF increased with BBs in all HF groups in sinus rhythm except LVEF ≥50%. |
Gu, J et al/2016 [39] | China | 803 patients | _ | _ | _ | _ | cohort study | _ | _ | BBs was associated with protective effects against incidence of new-onset symptomatic HFpEF, LV diastolic dysfunction and LVH. |
Hikoso, S et al/2024 [40] | Japan | 1159 patients | 44.7 | 81.4 | _ | _ | propensity-matched analysis | _ | _ | BBs were significantly associated with worse prognosis specifically in patients with HFpEF and high clinical frailty scale (CFS). |
Musse, M et al/2023 [41] | USA | _ | _ | _ | _ | _ | Observational study | _ | _ | A significant proportion of physicians prescribing BBs to patients with HFpEF, even without indications, and rarely deprescribe BBs. |
Ruiz, G et al/2016 [42] | Spain | 2704 patients | _ | _ | _ | _ | cohort study | _ | _ | Commencing treatment with bisoprolol or carvedilol, both at high and at lower doses, is associated with an improved prognosis of patients newly diagnosed with HFpEF. |
Yoon, M et al/2024 [43] | South Korea | 100 patients | _ | aged >= 20 | _ | _ | RCT | _ | LVEF ≥50% | Carvedilol improve diastolic dysfunction, cardiac remodeling, or NYHA functional class in HFpEF. |
Ibrahim, J et al/2024 [44] | USA | 20206 patients | _ | _ | _ | _ | cohort study | _ | _ | BBs use was associated with lower mortality in HFpEF patients with a recent decompensated HF hospitalization. |
Wernhart, S et al/2023 [45] | Germany | 99 patients | _ | _ | _ | _ | case-control study | _ | _ | BBs reduce exercise capacity and O2 pulse increase in HFpEF patients. Direct quantification of O2 pulse increase may help to improve the discrimination of HFpEF patients. |
Patel, L et al/2024 [46] | USA | 216 patients | 51.8 | 69 | _ | _ | RCT | _ | _ | BBs use was associated with a higher anaerobic threshold and lower QOL. |
Kamp, O et al/2010 [47] | Netherlands | 120 patients | _ | _ | _ | _ | cohort study | _ | _ | Nebivolol had no effect on 6MWT. |
Nevzorov, R et al/2012 [48] | Israel | 154 patients | _ | older than 18 years | _ | _ | cohort study | _ | _ | BBs may have protective effect on survival. |
Park, JJ et al/2019 [49] | South Korea | 1277 patients | _ | _ | _ | _ | cohort study | _ | _ | BBs is associated with improved survival in those with GLS < 14%. |
Domagoj, M et al/2019 [50] | Croati | ----- | _ | _ | _ | _ | comparative study | _ | _ | Long term carvedilol is associated with a higher overall survival rate, improvement in EF and NYHA class in HFpEF. |
Horiuchi, Y et al/2016 [51] | Japan | 81 patients | _ | _ | _ | _ | cohort study | _ | _ | Effects of BBs on LV remodeling were uncertain in AMI patients with HFpEF, who obtained complete coronary revascularization and received optimal MT. |
Gomez-Soto, FM et al/2011 [52] | Spain | 1085 adults | _ | _ | _ | _ | observational study | _ | _ | Bisoprolol or carvedilol is associated with a reduced mortality and morbidity of patients with newly diagnosed HFpEF. |
Takeda, Y et al/2004 [53] | Japan | 40 patients | _ | _ | _ | _ | RCT | _ | _ | Carvedilol decrease neurohumoral activation, decreased symptoms, and increased exercise capacity in patients with HFpEF. |
Li S et al/2019 [54] | China | 330 patients | 52.1 | 73 | _ | _ | Observational Study | ------- | EF ≥ 50% | BBs was associated with reduced mortality and a lower HR was associated with reduced mortality in HFpEF patients with SR. |
Loncar G et al/2012 [55] | Serbia | 219 elderly patients | _ | _ | _ | _ | RCT | _ | _ | After 12 weeks of BBs optimization copeptin might reflect successful up-titration faster than NT-proBNP in HFrEF, while the opposite was found in patients with HFpEF. |
Verbrugge FH et al/2013 [56] | Belgium | ------ | _ | _ | _ | _ | Comparative Study | _ | _ | No benefit of RAS- or BBs uptitration was observed in HFpEF. |
Kanorsky SG et al/2016 [57] | Russia | 126 patients | _ | _ | _ | _ | RCT | _ | _ | Bisoprolol was not improved METs, QOL, and reduced level of NT-proBNP precursor. |
Hamdani N et al/2009 [58] | Netherlands | 71 patients | _ | _ | _ | _ | RCT | _ | _ | Myocardial effects of BBs was include higher resting force, lower collagen volume fraction, lower cardiomyocyte diameter, and lower expression of stimulatory G protein. |
AF | Atrial Fibrillation |
BBs | Beta-Blockers |
BNP | B-type Natriuretic Peptide |
CAD | Coronary Artery Disease |
CKD | Chronic Kidney Disease |
COPD | Chronic Obstructive Pulmonary Disease |
CV | Cardiovascular |
CVD | Cardiovascular Disease |
EF | Ejection Fraction |
HF | Heart Failure |
HFmrEF | Heart Failure with Mildly Reduced Ejection Fraction |
HFpEF | Heart Failure with Preserved Ejection Fraction |
HFrEF | Heart Failure with Reduced Ejection Fraction |
HR | Heart Rate |
LVEF | Left Ventricular Ejection Fraction |
MACE | Major Adverse Cardiovascular Events |
NYHA | New York Heart Association |
QOL | Quality of Life |
RCT | Randomized Controlled Trial |
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APA Style
Khederlou, H., Rostamkhani, Z., Mohammadi, N., Ziaeinasab, M., Ghajar, M. (2026). A Narrative Review of Efficacy, Safety, and Prognostic Role of Beta-Blockers in Patients with Heart Failure with Preserved Ejection Fraction. Science Journal of Clinical Medicine, 15(3), 43-57. https://doi.org/10.11648/j.sjcm.20261503.12
ACS Style
Khederlou, H.; Rostamkhani, Z.; Mohammadi, N.; Ziaeinasab, M.; Ghajar, M. A Narrative Review of Efficacy, Safety, and Prognostic Role of Beta-Blockers in Patients with Heart Failure with Preserved Ejection Fraction. Sci. J. Clin. Med. 2026, 15(3), 43-57. doi: 10.11648/j.sjcm.20261503.12
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Download@article{10.11648/j.sjcm.20261503.12,
author = {Hamid Khederlou and Zahra Rostamkhani and Narges Mohammadi and Mobina Ziaeinasab and Mobina Ghajar},
title = {A Narrative Review of Efficacy, Safety, and Prognostic Role of Beta-Blockers in Patients with Heart Failure with Preserved Ejection Fraction},
journal = {Science Journal of Clinical Medicine},
volume = {15},
number = {3},
pages = {43-57},
doi = {10.11648/j.sjcm.20261503.12},
url = {https://doi.org/10.11648/j.sjcm.20261503.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20261503.12},
abstract = {Background: Medical management of Heart failure with preserved ejection fraction (HFpEF) remains uncertain, especially beta blockers (BBs) had various outcomes in studies. The objective of the present study is to review the efficacy and prognostic role of BBs in patients with HFpEF. Methods: A total of 58 articles were chosen for this narrative review from sources including web of science, PUBMED and Google Scholar. Results: Patients with HFpEF are more prevalent in female. The average age of patients is usually 70-80 years. The most important risk factors for this condition include advanced age, female gender, hypertension (HTN), diabetes mellitus (DM), coronary artery disease (CAD), and atrial fibrillation (AF). Despite a lack of evidence or indication, BBs are still extensively prescribed in HFpEF. In patients with HFpEF, BBs reduce blood pressure, left ventricular hypertrophy, and diastolic dysfunction by slowing heart rate and myocardial oxygen demand. BBs reduce blood pressure, but despite this, they do not improve the quality of life, cardiovascular events, and all-cause mortality. BBs may even be associated with an increased risk of HF hospitalization. In some studies, Carvedilol and Nebivolol were associated with improvement of functional capacity, NT Pro-BNP levels, and survival. Overally, using the BBs, recommended for patients of HFPEF with atrial fibrillation, hypertension, and coronary artery disease. Conclusion: BBs does not have a beneficial effect on quality of life and survival, and is also linked to a higher risk of HF-related hospitalizations. The use of BBs is not recommended for the treatment of HFpEF.},
year = {2026}
}
TY - JOUR T1 - A Narrative Review of Efficacy, Safety, and Prognostic Role of Beta-Blockers in Patients with Heart Failure with Preserved Ejection Fraction AU - Hamid Khederlou AU - Zahra Rostamkhani AU - Narges Mohammadi AU - Mobina Ziaeinasab AU - Mobina Ghajar Y1 - 2026/10/31 PY - 2026 N1 - https://doi.org/10.11648/j.sjcm.20261503.12 DO - 10.11648/j.sjcm.20261503.12 T2 - Science Journal of Clinical Medicine JF - Science Journal of Clinical Medicine JO - Science Journal of Clinical Medicine SP - 43 EP - 57 PB - Science Publishing Group SN - 2327-2732 UR - https://doi.org/10.11648/j.sjcm.20261503.12 AB - Background: Medical management of Heart failure with preserved ejection fraction (HFpEF) remains uncertain, especially beta blockers (BBs) had various outcomes in studies. The objective of the present study is to review the efficacy and prognostic role of BBs in patients with HFpEF. Methods: A total of 58 articles were chosen for this narrative review from sources including web of science, PUBMED and Google Scholar. Results: Patients with HFpEF are more prevalent in female. The average age of patients is usually 70-80 years. The most important risk factors for this condition include advanced age, female gender, hypertension (HTN), diabetes mellitus (DM), coronary artery disease (CAD), and atrial fibrillation (AF). Despite a lack of evidence or indication, BBs are still extensively prescribed in HFpEF. In patients with HFpEF, BBs reduce blood pressure, left ventricular hypertrophy, and diastolic dysfunction by slowing heart rate and myocardial oxygen demand. BBs reduce blood pressure, but despite this, they do not improve the quality of life, cardiovascular events, and all-cause mortality. BBs may even be associated with an increased risk of HF hospitalization. In some studies, Carvedilol and Nebivolol were associated with improvement of functional capacity, NT Pro-BNP levels, and survival. Overally, using the BBs, recommended for patients of HFPEF with atrial fibrillation, hypertension, and coronary artery disease. Conclusion: BBs does not have a beneficial effect on quality of life and survival, and is also linked to a higher risk of HF-related hospitalizations. The use of BBs is not recommended for the treatment of HFpEF. VL - 15 IS - 3 ER -
Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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