beta-blocker therapy: a standard of care for heart failure.

beta-Adrenergic-blocking agents underwent extensive research over the past 2 decades and emerged as a proven state-of-art therapy for the failing human heart. Through blockade of chronically elevated cardiac adrenergic stimulation, selective and nonselective agents with vasodilating properties prevent progression of myocardial dysfunction and cardiac remodeling. Most important, beta-adrenergic blockers added to conventional therapy of vasodilators and diuretics significantly increase survival to a 5-year rate similar to that of cardiac transplantation. The agents also significantly reduce hospitalizations, improve quality of life, and are well tolerated in clinical trials. The challenge in treating heart failure is to ensure that every eligible patient receives these life-saving drugs.