ß Blockers With ACE Inhibitors in Mild Heart Failure

ACE inhibitors are standard therapy for treating both symptomatic and asymptomatic patients with left ventricular dysfunction. However, recent clinical trials have shown that β blockers further reduce mortality in patients with symptomatic heart failure treated with ACE inhibitors. However, the evidence in support of adding β blockers to ACE inhibitor therapy in patients with asymptomatic left ventricular dysfunction is less certain. The mechanisms by which ACE inhibitors and β blockers may exert benefit in patients with heart failure are discussed, and studies assessing the association of β blockade with outcome in patients with mild heart failure receiving ACE inhibitor therapy are reviewed.