Tag Archives: Nepal

Our letter from Nepal below shows underuse of beta blockers is a widespread problem As outlined in the recent European Society of Cardiology (ESC) guidelines for the treatment of heart failure,1 the pivotal trials with beta blockers were conducted in patients with continuing symptoms and a persistently low ejection fraction (EF), despite treatment with an ACE inhibitor and, in most cases, a diuretic. Despite this, “there is consensus that these treatments are complementary and that a beta blocker and an ACE inhibitor should both be started as soon as possible after diagnosis of heart failure with reduced ejection fraction (HF-REF)”.1