The update on the rationale, use and selection of beta-blockers in heart failure.

Abstract

The purpose of this review was to describe important developments in the selection of beta-blockers in heart failure. The superiority of carvedilol over metoprolol tartrate in one clinical trial is demonstrated, and multiple studies investigated the potential mechanisms of benefit. Current practice patterns still demonstrate the importance of understanding barriers to the effective use of beta-blocking agents. There are continued refinements in the choice of beta-blockers in heart failure, but clearly an important remaining challenge is to modify health care delivery in an effort to maximize adherence to guidelines.