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It is important to distinguish between HFrEF and HFpEF when interpreting these data
  1. Brian Lipworth1,
  2. Derek Skinner2,
  3. Graham Devereux3,
  4. Victoria Thomas4,
  5. Joanna Ling Zhi Jie5,
  6. Jessica Martin6,
  7. Victoria Carter2,
  8. David B Price5,7
  1. 1 Scottish Centre for Respiratory Research, University of Dundee, Dundee, UK
  2. 2 Optimum Patient Care, Cambridge, UK
  3. 3 Applied Health Sciences, University of Aberdeen, Aberdeen, UK
  4. 4 Cambridge Research Support, Cambridge, UK
  5. 5 Observational and Pragmatic Research Institute, Singapore, Singapore
  6. 6 Research in Real Life, Cambridge, UK
  7. 7 Centre for Academic Primary Care, University of Aberdeen, UK
  1. Correspondence to Dr Brian Lipworth, Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee DD3 8LY, UK; b.j.lipworth{at}

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The Authors’ reply

We would like to thank Dr Cunnington for his interest in our study1 and raising some potentially interesting points.2 We do not have a breakdown of patients with heart failure (HF) who had either preserved (HFpEF) or reduced ejection fraction (HFrEF). Since β-blockers only have a licensed indication for HFrEF on the basis of an echocardiogram, we do not believe that this is likely to be a relevant factor within our dataset. The relative prevalence of hypertension within our cohort was 13.3% vs 11.6% and for diabetes was 47.4% vs 41.9%, respectively, for HF alone versus HF with chronic obstructive pulmonary disease (COPD). Hence, the assertion made regarding a higher putative comorbidity is not …

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