Should elderly heart failure patients be treated with 
-blockade therapy?
Karl Swedberg
Correspondence Department of Medicine, Sahlgrenska University Hospital/Östra, Göteborg, Sweden
Email karl.swedberg@hjl.gu.se
This article has no abstract so we have provided the first paragraph of the full text.
Chronic heart failure (CHF) is common and has high associated mortality, disability and costs. Within the past 10–15 years, pharmacologic treatment has dramatically improved, with significant reductions in mortality and morbidity.1 Combination treatment with angiotensin-converting-enzyme (ACE) inhibitors and 
-blockers is the major cause of this development. Following the CONSENSUS2 and SOLVD3 trials, ACE inhibitors were rapidly accepted as CHF treatment. -blockers were proposed as a therapy to improve CHF survival in 1979 but a major hesitance followed. In 1999, two important studies were presented which demonstrated that bisoprolol (the CIBIS II trial4) and metoprolol succinate (the MERIT-HF trial) improved survival; in 2001, these studies were followed by the COPERNICUS study, which showed the benefits of carvedilol.5 Despite the positive effects, the uptake of this beneficial treatment in the medical community has been slow, especially in elderly patients.
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