Beta-blocking Drugs in the Treatment of Congestive Heart Failure

Despite basic and elinical research in congestive heart failure, this disorder continues to remain a major challenge therapeutically and there is a need for innovative drugs that alter the prognosis of heart failure. In recent years, research directed toward understanding of the pathophysiology of congestive heart failure showed that the level of neurohumoral activation is the predictor of survival. Clinical studies documented that the inhibition of overactivated renin-angiotensin-aldosteron system by angiotensin-converting enzyme inhibitors may improve symptoms and mortality. There is also inercasing evidence of beneficial effects of beta blacking drugs which counteract the long-term deleterious effects of overstimulated sympathetic nervous system. Several trials strongly suggest that beta-blockers should be used for the manageınent of heart failure, especially in patients with dilated cardiomyopathy. Mortality data from the carvedilol studies are also encouraging. However, there is stili a need to await the result of planned large-scale trials in larger numbers of patients with different etiologies for routine usage of beta blackers in all patients with congestive heart failure.