Special clinical considerations of beta-blocker treatment

Outcomes for heart failure have improved considerably with the implementation of neurohormonal antagonism that includes angiotensin-converting enzyme inhibitors and β-blockers. Despite the robust benefit of β-blockers for heart failure, it is not clear that the benefit can be extended to all patient groups. Special clinical consideration thus needs to be given to the elderly, women, and African Americans. A retrospective review of available data suggests that despite differences in the natural history of heart failure for these groups, significant benefit can still be expected from the use of β-blockers for heart failure. Future trials will address these groups in a prospective manner.