Is Any Patient With Chronic Heart Failure Receiving the Right Dose of the Right Beta-Blocker in Primary Care?

Beta-blockers are our most effective class of drugs for the treatment of chronic heart failure. The efficacy of beta-blockers in patients with left ventricular systolic dysfunction has been established in more trials and the evidence supporting their use is more compelling than for any other single medication that physicians can prescribe for this disorder. By interfering with adrenergically-mediated cardiotoxicity, beta-blockers have been shown to consistently decrease the mortality of patients with heart failure by 30–40%; the magnitude of the survival benefit is greater than for angiotensin converting-enzyme inhibitors, angiotensin receptor blockers or mineralocorticoid receptor antagonists.