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Patient groups with chronic heart failure who should not be prescribed beta blockers

Authoring team

Patient groups with chronic heart failure who shouldn't be prescribed a beta-blocker (1):

  • contra-indicated in patients who have asthma with reversible airways obstruction - note however that most patients with chronic obstructive pulmonary disease (chronic bronchitis and emphysema) do not have much reversible airways obstruction and can be given beta-blockers safely
    • if in doubt, pulmonary function testing should be undertaken
  • peripheral vascular disease
    • most patients with peripheral vascular disease can be given beta-blockers safely, however they are contraindicated in critical limb ischaemia
  • beta-blockers should not be given to patients with decompensated heart failure and patients should be free of signs of fluid retention prior to commencement
  • beta-blockers should not be given to patients requiring intensive care for their heart failure in an ICU or when they are on inotropes
  • heart block
    • patients with second or third degree heart block should receive a pacemaker before beta-blockers are prescribed

Reference:

  1. British Heart Foundation. Factfile 4/06 - Use of beta blockers in heart failure.

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