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-Blockers in Heart Failure

Clinical Applications

Michael H. Farrell, MD; JoAnne Micale Foody, MD; Harlan M. Krumholz, MD

JAMA. 2002;287:890-897.

-Blockers reduce morbidity and mortality in heart failure patients with left ventricular systolic dysfunction and stable fluid status. The successful adoption of -blocker guidelines for these patients requires an understanding of the value of this therapy and effective systems to maintain safety and ensure high quality of care. This article distills scientific evidence and consensus guidelines into a series of cases and practical answers about patient selection, discussions with patients, management and monitoring, and systems improvements to optimize quality of care, safety, and benefit for all patients with heart failure.

Author Affiliations: Department of Internal Medicine, Sections of Cardiovascular Medicine (Drs Foody and Krumholz) and General Medicine (Dr Farrell), and the Section of Health Policy and Administration, Department of Epidemiology and Public Health (Dr Krumholz), Yale University School of Medicine, New Haven, Conn; and the Center for Outcomes Research and Evaluation, Yale–New Haven Hospital, New Haven, Conn (Dr Krumholz).

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