Beta-Blockers for Systolic Heart Failure - Topic Overview
How beta-blockers work
Beta-blockers are a class of drugs used
to control symptoms of
heart failure that are made worse by certain hormones
catecholamines. The body releases these hormones as
part of its
response to heart failure. For this and other reasons,
beta-blockers have been shown to be effective for treating most people who have
The symptoms of heart failure can be related to the pooling of fluid in the body or can be secondary to decreased blood flow to the body. Some people with heart failure don't experience symptoms, but here are some of the more common signs:
Shortness of breath with exercise or difficulty breathing at rest or when lying down
Swollen legs, ankles, or abdomen
Dry, hacking cough, or wheezing
Other symptoms may include:
Fatigue, palpitations, or pain during normal activities
Beta-blockers may work by slowing the heart rate, which allows
the left ventricle (the main pumping chamber of the heart) to fill more
Some of these medicines may also help open or widen blood vessels
in the body. This makes them especially useful in some people with certain
forms of heart failure who may also have high blood pressure.
Beta-blockers may be used to treat left ventricular systolic dysfunction
in people who are stable and have no symptoms or only mild to moderate heart
failure symptoms. Beta-blockers may be used together with other medicines
that are usually used to treat heart failure, such as angiotensin-converting
enzyme (ACE) inhibitors or diuretics.
Beta-blockers can slow the
systolic forms of heart failure in many people.
Beta-blockers are also used to treat heart failure with filling problems (diastolic heart failure) because they decrease the
heart rate, which gives the heart more time to relax between beats. This allows
the left ventricle to fill more completely and increases the volume of blood
that the heart pumps with each heartbeat (ejection fraction).
Beta-blockers may also slightly increase cholesterol levels.
Other less common side effects
Slow heartbeats (bradycardia)
Fluid buildup in the face, hands, legs, and feet
Increased wheezing in people with asthma
Cold hands and feet
What to think about
Beta-blockers are started only
after a person's
systolic heart failure has been stabilized using ACE
inhibitors and diuretics.
The effect of beta-blockers may depend
on the dosage used. A lower dose may have a different effect than a higher
dose. Beta-blocker therapy is typically started at a low dose and increased slowly
It may take a few months to
see the effects of beta-blocker medicine.
Beta-blockers have been
used for many years to treat high blood pressure (hypertension).