Beta-Blockers for Systolic Heart Failure

Topic Overview

When your heart begins to fail, your body tries to compensate for decreased blood flow by stimulating the heart to pump faster and more forcefully. Your nervous system does this by releasing a chemical called epinephrine into your blood and by releasing norepinephrine from nerve endings on the heart. At first, these chemicals (epinephrine and norepinephrine) increase the pumping action of your failing heart. But eventually increased levels of epinephrine can actually make your heart failure worse, probably by causing damage to the heart muscle cells over time.

Beta-blockers work by blocking the action of epinephrine and norepinephrine to slow your heart rate and reduce the strength of each contraction. Beta-blockers may actually cause your symptoms to get worse at first. But in the long term, beta-blockers can prevent worsening of heart failure and, in some cases, improve heart function. These medicines may also block the development of serious irregular heart rhythms and lower the risk of sudden death.

Because the beneficial effects of beta-blockers are so clear, doctors are more consistently prescribing them for all types of heart failure. Beta-blockers are considered a first choice in drug treatment for heart failure, along with diuretics and angiotensin-converting enzyme (ACE) inhibitors.

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Author Robin Parks, MS
Editor Kathleen M. Ariss, MS
Editor Marianne Flagg
Associate Editor Terrina Vail
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer Robert A. Kloner, MD, PhD - Cardiology
Last Updated August 25, 2008

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