Volume 9, Number 8, September 2002

GP use of beta blockers in heart failure
General practitioner Mike Mead gives a step-by-step guide on how to treat heart failure in primary care, including how to start patients on beta blockers.

This article explains how general practitioners can diagnose and treat heart failure in primary care. Diagnosis is difficult and four diagnostic tests – the electrocardiogram, chest x-ray, blood test for natriuretic peptides and echocardiography – are recommended as being of particular value in confirming the diagnosis in primary care.
A six-step treatment strategy is then given advising i) confirming the diagnosis, ii) excluding other treatable causes of heart failure, iii) giving general advice to the patient, iv) starting treatment with a diuretic, v) then adding an angiotensin-converting enzyme inhibitor, and, vi) finally adding a beta blocker. A 10-point plan explaining in detail how to start beta blockers in primary care concludes the article.

Br J Cardiol 2002;9:481-487.

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