β-Blockers in Heart Failure

Abstract

beta-Blockers reduce morbidity and mortality in heart failure patients with left ventricular systolic dysfunction and stable fluid status. The successful adoption of beta-blocker guidelines for these patients requires an understanding of the value of this therapy and effective systems to maintain safety and ensure high quality of care. This article distills scientific evidence and consensus guidelines into a series of cases and practical answers about patient selection, discussions with patients, management and monitoring, and systems improvements to optimize quality of care, safety, and benefit for all patients with heart failure.

Nebivolol compared with metoprolol for erectile function in males undergoing coronary artery bypass graft

“…Complications related to the use of beta-blockers are now being reconsidered in light of the development of more cardiac selective medications and increasing evidence of the long-term benefit of these drugs (24). The β 1 -adrenoceptor selectivity and vasoactive effects of three different generations (first-third generations) of beta-blockers are different.…”

Heart Failure in Community Practice: Relationship to Age and Sex in a β‐Blocker Registry

“…1, [16][17][18] Thus, the practical application of RCT results with β-blockers in HF has been questioned. 19,20 The Carvedilol Heart Failure Registry (COHERE) 21,22 recently reported experience with patients with HF in the community setting being started and followed on the β-blocker carvedilol. It must be emphasized that COHERE was not a clinical trial, but an observational study whose overall purpose was to characterize experience with carvedilol in unselected patients with HF treated by community physicians following standard practice without a structured protocol, and as an observational study it cannot test any hypothesis.…”

Preoperative β-Blocker Use and Mortality and Morbidity Following CABG Surgery in North America

“…URING THE PAST 2 DECADES, ␤-adrenergic blockade has been demonstrated to improve acute outcomes and long-term prognosis in ischemic heart disease. [1][2][3][4][5][6][7][8][9] ␤-Blocker therapy has also been demonstrated to reduce perioperative events among high-risk patients undergoing major noncardiac and vascular surgery. [10][11][12][13] To date, however, randomized studies have not examined whether ␤-blocker therapy is beneficial when used preoperatively in patients undergoing coronary artery bypass graft surgery (CABG).…”