Abstract 19599: Association of Alpha-Blocker Use with Heart Failure Hospitalization
Introduction: In ALLHAT, the use of alpha-blockers in hypertensive patients without preexisting heart failure (HF) was found to increase the risk of developing HF. Patients with existing HF are often prescribed alpha-blockers for benign prostatic hypertrophy or resistant hypertension. However, it is uncertain whether use of alpha-blockers can worsen existing HF. In this study, we assessed the impact of alpha-blockers on HF hospitalization/emergency room (ER) visits and all-cause hospitalization.
Methods: We conducted a retrospective cohort study, using chart abstraction from electronic medical records within a VA Healthcare System, of patients discharged alive after a hospital admission for a primary diagnosis of HF (ICD 9-CM-428.xx) between January 1, 2000 and December 31, 2012. Patients were grouped according to whether they were dispensed a prescription for an alpha-blocker on their HF discharge date. Multivariable logistic regression models were constructed to compare those receiving and those not receiving alpha-blockers for the primary outcome of HF hospitalization/ER visit within 2 years of discharge and the secondary outcome of all-cause hospitalization. Models were adjusted for demographics, comorbidities, and laboratory values that were significantly different between groups at baseline.
Results: Of 2,422 patients meeting the HF inclusion criteria, 688 (28%) were prescribed alpha-blockers.at HF discharge We randomly selected 503 patients (264 alpha-blocker, 239 control) to include in this study. Among these patients, 49.1% of patients in the alpha-blocker group and 37.9% of patients in the control group had a HF readmission/ER visits within 2 years of follow-up (aOR 1.76; 95% CI, 1.04 - 2.97; p=0.03; ARI=11.2%; NNH=9). Patients receiving alpha-blockers also had a trend toward higher risk of all-cause hospitalization (75.6% vs 65.1%; aOR 1.51; 95% CI; 0.85-2.69; p=0.16).
Conclusion: Alpha-blockers were associated with a significant increase in HF readmission/ER visits in HF patients within 2 years of follow-up. Consideration of the potential risks and benefits of alpha-blocker therapy in patients with HF is warranted.
Author Disclosures: C.A. Jackevicius: None. L. Lu: None. J. Cho: None. T. Lee: None. Z. Ghaznavi: None. A. Warner: None.
- © 2014 by American Heart Association, Inc.