Which class of medications is contraindicated in chronic heart failure?

The class of medications that is contraindicated in chronic heart failure is nonsteroidal anti-inflammatory drugs (NSAIDs). Chronic heart failure involves impaired cardiac function leading to fluid retention, and NSAIDs can exacerbate this condition by promoting sodium and water retention, increasing blood pressure, and potentially worsening heart failure symptoms.

NSAIDs inhibit the production of prostaglandins, which play a crucial role in renal blood flow and function. By reducing prostaglandin synthesis, these medications can lead to vasoconstriction of renal blood vessels, which can compromise kidney function and exacerbate fluid overload in patients with heart failure. This can lead to increased edema and worsening congestive symptoms, such as dyspnea and fatigue.

In contrast, the other classes of medications listed serve beneficial roles in managing chronic heart failure. ACE inhibitors are used to reduce mortality and morbidity through vasodilation and decreased workload on the heart. Beta blockers are important in improving heart function and outcomes, while diuretics help manage fluid overload and alleviate symptoms. Therefore, the contraindication of NSAIDs in chronic heart failure highlights the need for careful management to prevent exacerbation of the disease.