Physician Perspectives on the Use of Beta Blockers in Heart Failure With Preserved Ejection Fraction

Mahad Musse, Jennifer D. Lau, Brian Yum, Laura C. Pinheiro, Hannah Curtis, Timothy Anderson, Michael A. Steinman, Markus Meyer, Michael Dorsch, Scott L. Hummel, Parag Goyal

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


β-blockers are commonly used in heart failure with preserved ejection fraction (HFpEF), even in the absence of a compelling indication and despite the potential to cause harm. Identifying reasons for β-blocker prescription in HFpEF could permit the development of strategies to reduce unnecessary use and potentially improve medication prescribing patterns in this vulnerable population. We administered an online survey regarding β-blocker prescribing behavior to physicians trained in internal medicine or geriatrics (noncardiology physicians) and to cardiologists at 2 large academic medical centers. The survey assessed the reasons for β-blocker initiation, agreement regarding initiation and/or continuation of β-blockers by another clinician, and deprescribing behavior. The response rate was 28.2% (n = 231). Among respondents, 68.2% reported initiating β-blockers in patients with HFpEF. The most common reason for initiating a β-blocker was for treatment of an atrial arrhythmia. Notably, 23.7% of physicians reported initiating a β-blocker without an evidence-based indication. When a β-blocker was considered not necessary, 40.1% of physicians reported they were rarely or never willing to deprescribe. The most common reason for not deprescribing a β-blocker when the physician felt that a β-blocker was unnecessary was the concern about interfering with another physicians’ treatment plan (76.6%). In conclusion, a significant proportion of noncardiology physicians and cardiologists report prescribing β-blockers to patients with HFpEF, even when evidence-based indications are absent, and rarely deprescribe β-blockers in these scenarios.

Original languageEnglish (US)
Pages (from-to)70-74
Number of pages5
JournalAmerican Journal of Cardiology
StatePublished - Apr 15 2023

Bibliographical note

Publisher Copyright:
© 2023 Elsevier Inc.

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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