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Heart failure - chronic - Management
Basis for recommendation
Asthma
- Current guidelines from the National Institute for Health and Clinical Excellence (NICE) [National Clinical Guideline Centre for Acute and Chronic Conditions, 2010] and the European Society of Cardiology [European Society of Cardiology, 2008] both state that a history of asthma is a contraindication to the use of any beta-blocker, because these drugs can precipitate an asthma attack. The Commission on Human Medicines and the Medicines and Healthcare products Regulatory Agency also advises that beta-blockers (including those considered to be cardioselective) should not be given to people with a history of asthma or bronchospasm [CSM, 1996].
Chronic obstructive pulmonary disease (COPD)
- NICE recommends that people who have COPD without reversibility should be able to tolerate beta-blockers and are likely to benefit significantly from their use. NICE states that:
- These people are often undertreated when they develop heart failure and their outcomes are worse than the average person with heart failure.
- There is no evidence that cardioselective beta-blockers will worsen pulmonary function in these people.
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