ISBN: Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with Placebo Risk difference with Beta-blocker (95% CI) LOWb due to risk of bias (from 5 fewer to 60 fewer) All-cause mortality - CKD class 3-4 704 VERY LOWb,c due to risk of bias, imprecision (from 104 fewer to 7 more) Death or hospitalisation - CKD class 3a 669 VERY LOWb,c,e due to risk of bias, indirectness, imprecision Overalld (from 31 fewer to 165 fewer) Death or hospitalisation - CKD class 3b-4 235 VERY LOWb,c,e due to risk of bias, indirectness, imprecision Overalld (from 150 fewer to 18 more) Hospitalisation (time to event) - CKD class 3a 870 VERY LOWb,c due to risk of bias, imprecision (from 84 fewer to 31 more) Hospitalisation (time to event) - CKD class 3b-4 341 VERY LOWb,c due to risk of bias, imprecision (from 67 fewer to 248 fewer) Hospitalisation for cardiovascular disorder - CKD VERY LOWb,c,f due to risk of bias, (from 77 fewer to 56 more) Treating Heart Failure Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with Placebo Risk difference with Beta-blocker (95% CI) indirectness, imprecision HF hospitalisation - CKD class 3a 669 VERY LOWb,c,f due to risk of bias, indirectness, imprecision Overalld (from 5 fewer to 88 fewer) HF hospitalisation - CKD class 3b-4 450 VERY LOWb,c,f due to risk of bias, indirectness, imprecision Overalld (from 101 fewer to 25 more) Renal failure (not defined) 886 LOWb due to risk of bias Not estimableg Not estimabl eg Not estimableg VERY LOWb,c due to risk of bias, imprecision (from 8 fewer to 44 more) VERY LOWb,c due to risk of bias, imprecision Peto Odds (from 0 more to 10 more)i a Control risk taken from MERIT-HF b Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias c Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs d Data insufficient to calculate control risk. 