Three-year survival of patients with chronic symptomatic heart failure receiving hormone-guided treatment (red line), clinically-guided treatment (green line), or usual care (blue line). All patients irrespective of age are included. An overall treatment effect was confirmed by Cox hazards analysis at 1, 2, and 3 years (p < 0.05 for all analyses), driven mainly by a significant difference between hormone-guided and usual care groups (p = 0.011 over 3 years). The vertical dashed line indicates cessation of management strategy and return to standard clinical practice for all surviving participants at 2 years.

Survival among patients (A) 75 years of age and (B) >75 years of age with chronic symptomatic heart failure receiving hormone-guided treatment (red lines), clinically-guided treatment (green lines), or usual care (blue lines). Vertical dashed lines indicate cessation of treatment strategy and return to standard clinical practice for all surviving participants at 2 years. At 1 year, in the 75-year-old group, both hormone-guided and clinically managed groups had lower mortality than did the usual care group (p < 0.05 for both comparisons). At 3 years, the younger hormone-guided group had lower mortality than both other groups (p < 0.05 for both comparisons), and mortality in the clinically managed group no longer differed from that in the usual care group.