Beta-blocker therapy for patients with ventricular heart failure and reduced systolic function.

Approximately 5 million people in the United States are living with heart failure. The prevalence of heart failure is increasing as the mean age of the population of the US increases. Prognosis is poor: About half of all patients who have heart failure die within 5 years of onset. Management of heart failure has 3 major goals: (1) the specific treatment of the underlying cardiac disease; (2) relief of symptoms and improvement of quality of life; and (3) modification of the long-term neurohormonal progression. From clinical trial data, beta-blockers are recommended in national heart failure management guidelines as part of the standard therapy, along with diuretics, angiotensin-converting enzyme (ACE) inhibitors, and (usually) digoxin. Other agents such as angiotensin II-receptor blockers and mineralocorticoid (aldosterone) receptor antagonists may also be important.