Why are beta blockers preferred over amlodipine for rate control in heart failure?

Beta blockers are preferred over amlodipine for rate control in heart failure primarily because they reduce mortality in patients with this condition. Heart failure is a complex syndrome often associated with a variety of underlying causes, and its management focuses on improving symptoms, quality of life, and survival.

Beta blockers have been shown through various studies to have a significant beneficial effect on morbidity and mortality in heart failure patients. This is largely due to their ability to block the harmful effects of excessive sympathetic nervous system activation, which is often present in heart failure. By doing so, they help to improve cardiac function, decrease heart rate, and reduce the risk of arrhythmias.

In contrast, while amlodipine is a calcium channel blocker that can help manage blood pressure and may be used in heart failure, it does not provide the same survival benefit as beta blockers. Furthermore, amlodipine's mechanism primarily focuses on vasodilation and does not address the underlying pathophysiology associated with heart failure as effectively as beta blockers.

The other options, such as side effects and safety in hypertensive crises, do not provide the same level of impact on mortality and are not central to the rationale for choosing beta blockers in heart failure management.