Beta blockers for CHF. Adrenergic blockade dramatically reduces morbidity and mortality.
Several large clinical trials have shown that beta blockers can reduce morbidity and mortality in patients with CHF. Therefore, current guidelines for treatment of CHF now include beta blockers as standard therapy for patients with left ventricular systolic dysfunction (ejection fraction < or = 40%) and mild to moderate heart failure. Beta-blocker therapy for CHF should be started cautiously and increased gradually to avoid exacerbating symptoms of heart failure. At this time, data for therapy in patients with NYHA class I or IV symptoms are limited, and it is unclear whether all beta blockers confer benefit or whether some are better than others. Several trials are under way to answer these questions. Until more evidence is available, only those agents that have proved beneficial in mortality trials should be used to manage CHF.
Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, Chicago, USA.
R K
RK
Garg
M J
MJ
Sorrentino
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000075202:Contraindications; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000145:classification / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D009017:Morbidity; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012720:Severity of Illness Index; D013318:Stroke Volume; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000209:etiology
D000319:Adrenergic beta-Antagonists