Tolerability of beta-blockers in heart failure: reassurance needed, reassurance provided
Krum, H.
Italian Heart Journal Official Journal of the Italian Federation of Cardiology 4(4): 225-227
2003
ISSN/ISBN: 1129-471X PMID: 12784773 Document Number: 559182
In contrast to widely held perceptions regarding tolerability of beta-blockers in heart failure, it is clear that initiation and uptitration is not as complex as perceived. In particular, there is no increased risk of intolerance and/or worsening of heart failure symptoms with initiation of beta-blocker therapy (at least as demonstrated by carvedilol in COPERNICUS). Furthermore, the perceived delay in beneficial effects on outcomes is perhaps challenged by the COPERNICUS study. Interestingly, all of the above observations appear to hold true in patients with advanced disease. Because of the unique history of beta-blockers in systolic heart failure, physicians have needed particular reassurance regarding the tolerability of these agents. Reassurance regarding tolerability has now been definitively provided.