β-Adrenergic Blockers and Survival in Heart Failure

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Abstract
Only in the past decade have well-conducted clinical trials advanced the treatment of congestive heart failure from palliation to prolongation of life. In 1986, the Veterans Administration Cooperative Vasodilator–Heart Failure Trial I (V-HeFT I) established the principle that medical therapy (with hydralazine plus nitrates) could prolong survival in patients with symptomatic heart failure.1 On the heels of that study, angiotensin-converting–enzyme (ACE) inhibitors were definitively shown to improve survival in the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS) and the Studies of Left Ventricular Dysfunction (SOLVD).2,3 V-HeFT II then compared these therapies directly and showed that the survival benefit was . . .