ACE inhibitors and beta-blockers are clearly shown to improve survival in patients with heart failure and should be used in most patients.
Heart failure represents a complex clinical syndrome characterised by abnormalities of left ventricular function and neurohormonal regulation, exercise intolerance, shortness of breath, fluid retention, and reduced longevity.1 Despite improvements in treatment the prognosis for patients with heart failure remains poor: the risk of death annually is 5%-10% in patients with mild symptoms and 30%-40% in those with advanced disease.2 3 This condition is also associated with major morbidity and healthcare expenditure, being responsible for about 5% of hospital admissions in the United Kingdom.4 ### Box 1: Treatment of heart failure #### Aims #### Treatment modalities Mitral valve surgery Coronary revascularisation Surgical ventricular remodelling procedures Cardiomyoplasty Dual chamber pacing Implantable cardioverter defibrillator treatment Ventricular assist devices Artificial heart Heart transplantation This review deals only with pharmacological treatments in chronic heart failure. Non-pharmacological measures apply to all patients, whereas surgical and device treatments (many still experimental) apply only to specific patient subsets. Patients with clinical symptoms of heart failure but normal or near normal left ventricular systolic function often have impaired left ventricular diastolic function. This heterogeneous group has been generally excluded from heart failure trials. We do not discuss the treatment of diastolic left ventricular dysfunction or acute heart failure syndromes: more comprehensive reviews are available.5 ### Summary points The prognosis for patients with heart failure remains poor Drugs clearly shown to improve survival in patients with heart failure are ACE inhibitors and βblockers These drugs should be used in most patients with heart failure but require …
E Lonn (Sat,) studied this question.