Advanced Note: Using Beta Blockers in the Treatment of Heart Failure:

β-Blockers are a critical component of Heart Failure therapy and work by blocking the toxic effects of chronic adrenergic stimulation on the heart. Large, randomized trials have documented the beneficial effects of β-blockers on functional status, disease progression, and survival in patients with NYHA class II–IV symptoms. Typically, 2–3 months of therapy is required to observe significant effects on LV function, but reduction of cardiac arrhythmia and incidence of sudden cardiac death (SCD) may occur much earlier. Note (1): β-Blockers should be instituted at a low dose and titrated with careful attention to blood pressure and heart rate. Note (2) Some patients experience volume retention and worsening HF symptoms that typically respond to transient increases in diuretic therapy. The survival benefit of β-blockers is proportional to the heart rate reduction achieved. Individual β-blockers have unique properties thus β-blockers with proven benefit on mortality in large clinical trials should be used in the treatment of Heart Failure unless there is a Contraindication to using them. These include: 1- Carvedilol 2- Metoprolol succinate 3- Bisoprolol

More information is available at: The Washington Manual of Medical Therapeutics Paperback 36th Edition by Dr. Zachary Crees MD (Author), Dr. Cassandra Fritz MD

(Editor), Dr. Alonso Huedebert MD (Editor), Dr. Jonas Noe MD (Editor), & 2

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