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Heart failure beta-blocker titration — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsHeart failure beta-blocker titrationGPhC CRA

A 68-year-old man with heart failure with reduced ejection fraction presents with a new prescription for bisoprolol 1.25 mg daily. He is euvolaemic and already takes ramipril and furosemide. He is concerned because beta-blockers can worsen heart failure. What is the most appropriate action?

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Correct answer: A — Reassure him and advise slow dose titration with monitoring

Bisoprolol is an evidence-based beta-blocker for stable heart failure with reduced ejection fraction, introduced at a low dose and titrated gradually. It should not be initiated during acute decompensation. Verapamil is generally avoided in HFrEF because of negative inotropic effects.

Reference: BNF; NICE CKS