{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T22:24:49Z","timestamp":1769120689553,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["18IPA34170185"],"award-info":[{"award-number":["18IPA34170185"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR001086"],"award-info":[{"award-number":["UL1TR001086"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23HL142835"],"award-info":[{"award-number":["K23HL142835"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P01AG019783"],"award-info":[{"award-number":["P01AG019783"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>Neurohormonal therapy, which includes beta\u2010blockers and angiotensin\u2010converting enzyme inhibitor\/angiotensin receptor blockers (ACEi\/ARBs), is the cornerstone of heart failure with reduced ejection fraction (HFrEF) treatment. While neurohormonal therapies have demonstrated efficacy in randomized clinical trials, older patients, which now comprise the majority of HFrEF patients, were underrepresented in those original trials. This study aimed to determine the association between short\u2010 (30\u2009day) and long\u2010term (1\u00a0year) mortality and the use of neurohormonal therapy in HFrEF patients, across the age spectrum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design\/Setting\/Participants<\/jats:title>\n                    <jats:p>This is a population\u2010based, retrospective, cohort study between January 2008 and December 2015. We used 100% Medicare Parts A and B and a random 40% sample of Part D to create a cohort of 295,494 fee\u2010for\u2010service beneficiaries with at least one hospitalization for HFrEF between 2008 and 2015. All analyses were performed between May 2019 and July 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>We used Part D data to determine exposure to beta\u2010blocker and ACEi and ARB therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found that in 295,494 patients admitted for HFrEF between 2008 and 2015, the average age was 80\u2009years, 54% were female and 17% were non\u2010white. The baseline mortality rate was higher among those aged \u226585, but the mortality benefits of neurohormonal therapy were preserved across the age spectrum. Among those \u226585\u2009years old, the hazard ratio for death within 30\u2009days was 0.59 (95% confidence interval [CI] 0.56\u20130.62;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) for beta\u2010blockers and 0.47 (95% CI 0.44\u20130.49;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) for ACEi\/ARBs. The hazard ratio for death within 1\u00a0year was 0.37\u20130.56 (95% CI 0.35\u20130.58;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) for beta\u2010blockers and 0.38\u20130.53 (95% CI 0.37\u20130.55;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) for ACEi\/ARB.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At a population level, neurohormonal therapy was associated with lower short\u2010 and long\u2010term mortality across the age spectrum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.17310","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T10:34:46Z","timestamp":1623753286000},"page":"2811-2820","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The association between neurohormonal therapy and mortality in older adults with heart failure with reduced ejection fraction"],"prefix":"10.1111","volume":"69","author":[{"given":"Lauren","family":"Gilstrap","sequence":"first","affiliation":[{"name":"Heart and Vascular Center, Section of Cardiology Dartmouth\u2010Hitchcock Medical Center  Lebanon New Hampshire USA"},{"name":"The Dartmouth Institute, Geisel School of Medicine  Hanover New Hampshire USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea M.","family":"Austin","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute, Geisel School of Medicine  Hanover New Hampshire USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Gladders","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Section of Cardiology Dartmouth\u2010Hitchcock Medical Center  Lebanon New Hampshire USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7474-3737","authenticated-orcid":false,"given":"Parag","family":"Goyal","sequence":"additional","affiliation":[{"name":"Division of Cardiology Weill Cornell Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. James","family":"O'Malley","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute, Geisel School of Medicine  Hanover New Hampshire USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber","family":"Barnato","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute, Geisel School of Medicine  Hanover New Hampshire USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna N. 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