The use of β-blockers in patients with heart failure and comorbidities: Doubts, certainties and unsolved issues

β-blockers represent a mainstay in the pharmacological approach to patients affected by heart failure with reduced ejection fraction (HFrEF). However, underuse of this class drugs is still reported, especially presence cardiovascular and non-cardiovascular comorbidities, even if they are not contraindications for prescription β-blocker. The prognostic benefit relevant achievement maximum tolerated dose an important goal increase their favorable role. aim present review analyze available evidence on use HFrEF most common comorbidities. In particular, we will discuss role appropriate beta-blocker pulmonary disease (bisoprolol, metoprolol, nebivolol), diabetes (carvedilol atrial fibrillation (all indicated rate control, metoprolol as first choice followed bisoprolol, nebivolol, carvedilol), erectile dysfunction (bisoprolol peripheral arterial (nebivolol), other conditions, order clarify correct clinical practice.