“…Ten observational studies 10,25,37,[39][40][41][42][43][44] (n=363,784) reported similar findings in people with HFpEF 43 but increased risk in HFrEF. Discontinuation of beta-blockers in hospitalised HFrEF patients with ADHF showed 2-fold risk of mortality (RR 2.06, 95%CI 1.31-3.24, five-studies, n=178,849, I 2 =69%, very low-quality evidence, eFigure 4b) 25,39,41,42,44 and 7% increased risk of 1-year readmission compared to continuation (HR 1.07, 95%CI 1.02 to 1.13, 2-studies, n=357,782, I 2 =3%, moderate-quality evidence, Figure 2) 40,44 and no statistical difference in risk of 8-52-week hospitalisation (RR 1.00, 95% CI 0.84 to 1.19, four-studies, n=362,136, I 2 =69%, very low-quality evidence, eFigure 6b) 25,40,41,44 . ADWEs included ventricular arrythmia (n=8, 5%), AF (n=44, 3%), acute coronary artery syndrome (n=12, 8%) and syncope (n=3, 2%); but no significant change in activities of daily living (ADLs).…”