Beta-Blockers Are Indeed Safe for Heart Failure

Perhaps because beta-blockers were once considered contraindicated in heart-failure (HF) patients, some clinicians remain reluctant to prescribe them to these patients despite proven morbidity and mortality benefits. To address persistent doubts, researchers quantified the adverse-event risks of beta-blocker use in HF patients using data from nine randomized, placebo-controlled trials of four drugs (carvedilol, metoprolol, bucindolol, and bisoprolol) involving 14,594 patients. Follow-up ranged from 6 to 24 months.

Of course, beta-blocker therapy yielded a significant reduction in all-cause mortality compared with placebo. Significantly fewer beta-blocker than placebo recipients were withdrawn from therapy during the trials, primarily because…