The rational use of β-adrenoceptor blockers in the treatment of heart failure. The changing face of an old therapy

Heart failure is one of the commonest debilitating conditions of industrialized society, with mortality and morbidity comparable with that of the common neoplastic diseases. The role of antagonists of the adrenergic β-receptor (β-blockers) in heart failure has been the subject of debate for many years. Data from studies of the therapeutic use of β-blockers in patients following acute myocardial infarction suggest that in this circumstance these agents confer at least as much benefit to patients with heart failure as they do to those without. Similarly retrospective analysis of a number of the studies of angiotensin converting enzyme (ACE) inhibitors in heart failure suggest a greater effect of the combination of β-blocker with ACE inhibitor compared with ACE inhibitor alone