{"doi":"10.1001/jamanetworkopen.2025.29519","title":"β-Blocker Use and Health Status Among Patients With Heart Failure With Preserved Ejection Fraction","abstract":"Importance: β-Blockers are widely used for patients with heart failure with preserved ejection fraction (HFpEF). However, their association with health status among this population remains unknown. Objective: To evaluate the association of β-blocker use with health status among patients with HFpEF. Design, Setting, and Participants: This cohort study was a secondary analysis of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist randomized clinical trial, which enrolled 3445 patients with HFpEF (left ventricular ejection fraction [LVEF] ≥45%) to receive spironolactone or placebo. We excluded 1678 patients from Georgia or Russia and 41 with missing baseline Kansas City Cardiomyopathy Questionnaire overall summary score (KCCQ-OS) or β-blocker data, resulting in an analytic cohort of 1726 patients enrolled between August 10, 2006, and January 31, 2012. Statistical analysis was performed from July to November 2024. Exposure: β-Blocker use. Main Outcomes and Measures: Heath status was assessed with the KCCQ-OS, a heart failure-specific health status patient-reported outcome measure. The cross-sectional association of β-blocker use and baseline KCCQ-OS was assessed using multivariable linear regression, adjusted for demographic and clinical factors, and testing the interaction of β-blocker × LVEF. A second model examined changes in KCCQ-OS from baseline to 4 months and tested the interaction between β-blocker use and spironolactone to examine whether β-blockers were associated with modification of the health status benefit of spironolactone. Results: Among 1726 patients with HFpEF (mean [SD] age, 71.6 [9.7] years; 862 women [49.9%]; mean [SD] LVEF, 58.1% [7.7%]), 1356 (78.6%) were receiving β-blockers at baseline. β-Blocker use was not significantly associated with concurrent KCCQ-OS (mean difference, -1.1 points [95% CI, -3.7 to 1.4 points]; P = .38). This association did not significantly differ by LVEF, although patients with LVEF of 65% or more who used β-blockers had a numerically lower KCCQ-OS score (mean difference, -6.1 points [95% CI, -12.3 to 0.0 points]) compared with LVEF of 55% to 64% (mean difference, 0.0 points [95% CI, -3.9 to 3.8 points) and LVEF of 45% to 54% (mean difference, -0.2 points [95% CI, -4.3 to 3.8 points]) (P = .21 for interaction). In the longitudinal model, β-blockers were not associated with modification of the health status benefits of spironolactone at 4 months (mean difference, 2.9 points [95% CI, -1.0 to 4.9 points] with β-blockers vs 0.1 [95% CI, -3.7 to 3.9 points] without; P = .20 for interaction). Conclusions and Relevance: In this cohort study of patients with HFpEF, β-blocker use was not associated with better or worse baseline health status or the modification of the health status benefits of spironolactone at 4 months. Further research is needed to better understand the association of β-blockers with health status among patients with HFpEF.","journal":"JAMA Network Open","year":2025,"id":539868,"datarank":0.3602409178182485,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"self_citation_contribution":0.24141568686511508,"citation_network_contribution":0.11882523095313346,"self_endowment_contribution":0.24141568686511508,"citer_contribution":0.11882523095313346,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":4,"citers_with_citation_signal":2,"citers_with_endowment":2,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9413,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":31026,"name":"John A. Spertus","orcid":"0000-0002-2839-2611","position":1,"is_corresponding":false},{"id":1427356,"name":"Y Cho","orcid":"0009-0000-0709-7325","position":2,"is_corresponding":false},{"id":312388,"name":"Philip G. Jones","orcid":"0000-0002-7136-4464","position":3,"is_corresponding":false},{"id":239732,"name":"Suzanne V. Arnold","orcid":"0000-0003-3367-0302","position":4,"is_corresponding":false},{"id":1262770,"name":"Mohammad Abdel Jawad","orcid":null,"position":0,"is_corresponding":true}],"reference_count":10,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:52:34.520788Z","pmid":"40875231","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}