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Heart failure beta-blocker selection — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsHeart failure beta-blocker selectionGPhC CRA

A 72-year-old man with heart failure with reduced ejection fraction is reviewed after stabilisation on ramipril and furosemide. His pulse is 82 bpm, blood pressure is 128/76 mmHg and he has no acute fluid overload. The GP asks which beta-blocker to start. What is the most appropriate alternative?

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Correct answer: A — Bisoprolol

Heart failure with reduced ejection fraction should be treated with an evidence-based beta-blocker when the patient is clinically stable. Bisoprolol is one of the beta-blockers licensed and commonly used for this indication. Non-selective or antiarrhythmic beta-blockers are not appropriate substitutes for routine heart failure optimisation.

Reference: NICE CKS; BNF