How should beta-blockers be prescribed for patients with congestive heart failure?
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Beta-blockers should be prescribed at low initial doses and gradually titrated every 2 weeks to research-validated targets or the maximally tolerated dose. Two-thirds of patients will not achieve target doses. (SOR A, based on multiple randomized controlled trials [RCTs].) If worsening of heart failure symptoms occur during titration, the doses of diuretics (SOR B, based on multiple RCTs) or other concomitant medications (SOR C, based on expert opinion) should be adjusted.
Evidence Based Practice 12(3): 09.