Beta blockers improve survival and reduce morbidity of @entity1 with @entity712 . Stringent dosing guidelines calling for a 1-hour observation period after initiation or up-titration of beta-blocker therapy might limit the use of beta blockers and increase the expense involved. This study was conducted to determine the usefulness of this observation period. Data were collected from 130 in-clinic postdosing observation periods for 34 stable @entity712 @entity1 started on @entity1405 . The mean left ventricular ejection fraction was 0.22  0.09, and the mean functional class was 2.5  0.6. No @entity1 had greater than first-degree @entity616 . @entity1405 was started at 3.125 or 6.25 mg b.i.d., and the dose was doubled every 1-3 weeks. All @entity1 were observed for 1-2 hours after initiation or dosage increase, and blood pressure and heart rate were measured hourly. The maximal daily dose was 50  31 mg. In none of the observation periods was there a decrease in the dose of beta blockers administered in the clinic. The predosing mean blood pressure was 110  15/71  10 mm Hg, and the mean heart rate was 78  13 bpm; the 1-hour postdosing mean blood pressure was 101  14/67  10 mm Hg (p is less than 0.001), and the heart rate was 78  13 bpm. The dose was decreased in six @entity1 and medication was discontinued in three, all consequent to symptoms reported several days after dosage increase. Beta blockers can be safely initiated and up-titrated at home in properly selected and evaluated stable @entity1 with @entity712 and severe @entity1002 resulting in mild or moderate impairment of functional capacity. (c)2001 by CHF, Inc.

Clinic dosing of beta blockers in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity712 :: ('MESH:D006333', 'Disease') :: ['chronic heart failure'] @entity1405 :: ('MESH:C043211', 'Chemical') :: ['carvedilol', 'Carvedilol'] @entity616 :: ('MESH:D006327', 'Disease') :: ['heart block'] @entity1002 :: ('MESH:D018487', 'Disease') :: ['left ventricular dysfunction']
@entity712 :: (MESH:D006333,Disease) :: ['chronic heart failure']
