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For symptom control, all patients should be offered a β-blocker, unless contra-indicated (e.g. asthma, bradycardia <50bpm).

COPD is not a contra-indication.

β-blockers have also been shown to reduce mortality if started soon after a coronary event (as well as helping angina control and blood pressure management if required).

If not already on a β-blocker and less than 5 years since MI/ACS, then start a β-blocker.

Click here for further information.

For mortality benefit and symptom control, Atenolol 25 mg bd is the recommended drug and starting dose (except in heart failure patients - click here for LVSD guideline).