The use of beta-adrenergic receptor antagonists in the treatment of African Americans with heart failure.

The addition of beta-adrenergic antagonists to the treatment regimen for heart failure has validated the neurohormonal hypothesis and provided much-improved outcomes. This benefit had been in question for African Americans based on past experiences in the field of hypertension and worrisome data reported from the Beta Blocker Evaluation of Survival Trial. However, the totality of data now demonstrate that African Americans respond favorably to beta blockers and are capable of having the same outcomes in response to medical therapy for heart failure. There should be no reluctance, nor is there an appropriate rationale, to withhold beta-blocker therapy for heart failure to any patient with left ventricular dysfunction without an overt contraindication. The first prospective trial in African Americans with heart failure, the African American Heart Failure Trial (A-HeFT), is ongoing and provides additional insight into the best treatment strategies for this patient population.