Treatment of heart failure with ACE inhibitors and beta-blockers

Abstract

Angiotensin converting enzyme (ACE) inhibitors and beta-blockers have together become the backbone of the treatment of chronic heart failure (CHF) as both classes of drugs have been shown to reduce morbidity and mortality [1]. In addition, patients with CHF generally receive a number of other drugs, which include diuretics, digoxin, vasodilators (like nitrates, and calcium channel blockers), anti-arrhythmic drugs, anticoagulants, and more recently statins. Although these latter classes of drugs may be indicated for special indications (such as atrial fibrillation) none of them has been overall shown to improve outcome. This is in contrast with two other classes of drugs which were found to further reduce morbidity and mortality in patients with CHF when added to maximal medication, i.e. angiotensin II receptor blockers (ARBs) and aldosterone receptor antagonists (ARAs) [2–5].