b Receptor antagonists lacking intrinsic sympathomimetic activity, administered during the early phases of acute myocardial infarction and continued long-term, may decrease mortality by ~25%.
CONGESTIVE HEART FAILURE The reflex sympathetic responses to heart failure may stress the failing heart and exacerbate the progression of the disease, and blocking those responses is beneficial (see Chapter 33). b Receptor antagonists are highly effective treatment for all grades of heart failure secondary to left ventricular systolic dysfunction. The drugs improve myocardial function and the quality of life, and prolong life. Thus, b blockers have moved from being con-traindicated to being the standard of care in many settings of heart failure.
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