[Pharmacotherapy of chronic heart failure]

In recent years improvement of pharmacotherapy has led to a reduction of morbidity and mortality of heart failure patients. According to current evidence therapy of chronic heart failure should include ACE inhibitors and beta-Blockers to relieve symptoms and improve prognosis. In patients with fluid overload diuretics should be added. If symptoms persist or in patients with atrial fibrillation cardiac glycosides are indicated. Additional spironolactone can reduce mortality in patients with NYHA class III-IV. If ACE inhibitors are not tolerated or contraindicated AT1 receptor blockers should be considered as second line drugs. Evidence-based management strategies can improve prognosis in heart failure but medication has to be individualized for every patient depending on the presence of comorbid conditions.