Beta blocker therapy for chronic heart failure.

Recent studies have shown that beta blocker therapy improves survival and reduces hospitalizations in patients who have chronic heart failure and left ventricular systolic dysfunction, the majority of whom are under the management of primary care physicians. Appropriate patient selection is essential to the successful initiation of beta blocker therapy. Candidates should be stable in New York Heart Association functional class II or III. Patients with severe heart failure, especially inotrope-dependent and hospitalized patients, and those with hypotension, bradycardia or higher than first-degree heart block are not considered appropriate candidates for beta blocker therapy. Optimal diuresis is essential for maximal tolerability. Beta blockers should be started at the lowest dose, with the dose increased every two to four weeks until the target dose or highest tolerated dose is reached. Close monitoring allows for the detection and appropriate management of side effects, such as hypotension, bradycardia and increased congestion. The treatment goal is long-term improvement of prognosis, rather than immediate improvement of symptoms.

作 者：

Ramahi,TM

刊 名：

American Family Physician 

年，卷(期)：

2000V.62,no.10,2000("") 

分类号：

 

关键词：

Adrenergic beta-Antagonists  Heart Failure, Congestive  Ventricular Dysfunction, Left  肾上腺素能β受体拮抗剂  心力衰竭, 充血性  心室功能障碍, 左

正文语种：

eng 

基金项目：