{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T21:44:26Z","timestamp":1769118266759,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,9,5]],"date-time":"2017-09-05T00:00:00Z","timestamp":1504569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["RC1 HL099395"],"award-info":[{"award-number":["RC1 HL099395"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U19 HL91179"],"award-info":[{"award-number":["U19 HL91179"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R21 AG045320"],"award-info":[{"award-number":["R21 AG045320"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R24 AG045050"],"award-info":[{"award-number":["R24 AG045050"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2017,12]]},"abstract":"\n Objectives<\/jats:title>\n \n To assess the clinical effectiveness of beta\u2010blocker therapy in individuals with heart failure (\n HF<\/jats:styled-content>\n ) and chronic lung disease and of angiotensin\u2010converting enzyme inhibitors (\n ACE<\/jats:styled-content>\n \u2010Is) and angiotensin\n II<\/jats:styled-content>\n receptor blockers (\n ARB<\/jats:styled-content>\n s) in individuals with\n HF<\/jats:styled-content>\n and chronic kidney disease.\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Community.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n \n Individuals with\n HF<\/jats:styled-content>\n with reduced ejection fraction (\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n ) or\n HF<\/jats:styled-content>\n with preserved ejection fraction (\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We undertook separate new\u2010user cohort studies to assess the effectiveness of beta\u2010blocker therapy in treating\n HF<\/jats:styled-content>\n and chronic lung disease and\n ACE<\/jats:styled-content>\n \u2010Is and\n ARB<\/jats:styled-content>\n s in treating\n HF<\/jats:styled-content>\n and chronic kidney disease (\n CKD<\/jats:styled-content>\n ). Individuals with a chronic lung disease diagnosis were included in the group with\n HF<\/jats:styled-content>\n and chronic lung disease (\n International Classification of Diseases, Ninth Revision<\/jats:italic>\n , codes 490\u2013496, 518). Individuals with an estimated glomerular filtration rate less than 60\n mL<\/jats:styled-content>\n \/min per 1.73 m\n 2<\/jats:sup>\n were included in the group with\n HF<\/jats:styled-content>\n and\n CKD<\/jats:styled-content>\n . The clinical outcomes of interest were death from any cause, hospitalization for\n HF<\/jats:styled-content>\n , and hospitalization for any reason. We fitted pooled logistic marginal structural models using inverse probability weighting, stratified according to\n HF<\/jats:styled-content>\n type.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n For individuals with\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n with chronic lung disease, beta\u2010blocker therapy was protective against death (relative risk (\n RR<\/jats:styled-content>\n ) = 0.58, 95% confidence interval (\n CI<\/jats:styled-content>\n ) = 0.44\u20130.77) and hospitalization for\n HF<\/jats:styled-content>\n (\n RR<\/jats:styled-content>\n = 0.78, 95%\n CI<\/jats:styled-content>\n = 0.60\u20131.00). For those with\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n , no statistically significant associations between beta\u2010blocker therapy use and any of the outcomes were observed. We found\n ACE<\/jats:styled-content>\n \u2010I and\n ARB<\/jats:styled-content>\n use to be protective against all three outcomes of interest in individuals with\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n (death from any cause:\n RR<\/jats:styled-content>\n = 0.60, 95% 0.40\u20130.91; hospitalization for\n HF<\/jats:styled-content>\n :\n RR<\/jats:styled-content>\n = 0.43, 95%\n CI<\/jats:styled-content>\n = 0.28\u20130.67; hospitalization for any reason:\n RR<\/jats:styled-content>\n = 0.63, 95%\n CI<\/jats:styled-content>\n = 0.45\u20130.89, respectively) and those with\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n (death from any cause:\n RR<\/jats:styled-content>\n = 0.52, 95%\n CI<\/jats:styled-content>\n = 0.33\u20130.81; hospitalization for\n HF<\/jats:styled-content>\n :\n RR<\/jats:styled-content>\n = 0.35, 95%\n CI<\/jats:styled-content>\n = 0.18\u20130.68; hospitalization for any reason:\n RR<\/jats:styled-content>\n = 0.67, 95%\n CI<\/jats:styled-content>\n = 0.47\u20130.95).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Large observational studies may allow for identification of important subgroups of individuals with\n HF<\/jats:styled-content>\n that might benefit from existing treatment approaches. Our findings may also better inform the design of more\u2010definitive future observational studies and randomized trials.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgs.15062","type":"journal-article","created":{"date-parts":[[2017,9,5]],"date-time":"2017-09-05T08:37:24Z","timestamp":1504600644000},"page":"2610-2618","source":"Crossref","is-referenced-by-count":8,"title":["Treatment Effectiveness in Heart Failure with Comorbidity: Lung Disease and Kidney Disease"],"prefix":"10.1111","volume":"65","author":[{"given":"Jerry H.","family":"Gurwitz","sequence":"first","affiliation":[{"name":"Meyers Primary Care Institute University of Massachusetts Medical School Fallon Community Health Plan and Reliant Medical Group Worcester Massachusetts"},{"name":"Department of Quantitative Health Sciences University of Massachusetts Medical School Worcester Massachusetts"},{"name":"Department of Medicine University of Massachusetts Medical School Worcester 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A.","family":"Allen","sequence":"additional","affiliation":[{"name":"Colorado Cardiovascular Outcomes Research Consortium Denver Colorado"},{"name":"School of Medicine University of Colorado Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David D.","family":"McManus","sequence":"additional","affiliation":[{"name":"Meyers Primary Care Institute University of Massachusetts Medical School Fallon Community Health Plan and Reliant Medical Group Worcester Massachusetts"},{"name":"Department of Quantitative Health Sciences University of Massachusetts Medical School Worcester Massachusetts"},{"name":"Department of Medicine University of Massachusetts Medical School Worcester Massachusetts"},{"name":"Department of Biomedical Engineering Worcester Polytechnic Institute Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Meyers Primary Care Institute University of Massachusetts Medical School Fallon Community Health Plan and Reliant Medical Group Worcester Massachusetts"},{"name":"Department of Quantitative Health Sciences University of Massachusetts Medical School Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayra","family":"Tisminetzky","sequence":"additional","affiliation":[{"name":"Meyers Primary Care Institute University of Massachusetts Medical School Fallon Community Health Plan and Reliant Medical Group Worcester Massachusetts"},{"name":"Department of Quantitative Health Sciences University of Massachusetts Medical School Worcester Massachusetts"},{"name":"Department of Medicine University of Massachusetts Medical School Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan S.","family":"Go","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California Oakland California"},{"name":"Department of 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