Carvedilol in elderly patients with chronic heart failure, a 12 weeks randomized, placebo controlled open trial

The encouraging results of recent multicenter clinical trials conducted in the US on the effect of carvedilol therapy in patients with chronic heart f ailure, prompted us to verify its tolerability in a group of elderly patien ts. For the open, randomized, placebo-controlled study, we selected 40 pati ents (28 men and 12 women, mean age 76.8 +/- 5.9 years) with mild, moderate or severe chronic heart failure. Exclusion criteria included dementia, chr onic hepatitis, renal failure, severe Vascular disease and respiratory fail ure. All patients were receiving treatment with digitalis, furosemide and A CE inhibitors. The study lasted 12 weeks. During the first week, all subjec ts received oral placebo or carvedilol, at a dose of 6.25 mg twice daily. T he twice daily dose was then increased to 12.5 mg during weeks 2-4 and to 2 5 mg from weeks 5-12. At 0, after the 2 weeks of run-in, 4 and 12 weeks pat ients underwent assessment of systolic and diastolic blood pressure, heart rate, left Ventricular ejection fraction, cognitive status and functional a bility. Our findings indicate that elderly patients with congestive heart f ailure tolerate carvedilol therapy well. Carvedilol slightly improves heart function without altering functional or cognitive ability. A larger-scale trial in geriatric patients is now required to determine whether this treat ment will reduce serious morbidity or mortality from heart failure. (C) 199 9 Elsevier Science Ireland Ltd. All rights reserved.