Drug therapy of heart failure

While the incidence of cardiovascular disorders has decreased over the past 10 to 20 years, the incidence of congestive heart failure (CHF) has more than tripled. Although much has been learned about the pathophysiology of CHF, the annual mortality rate continues to be high and the impact of medical management is still less than optimal. The goals of therapy are to minimize or eliminate any underlying causes, reduce sodium and water retention, reduce the workload of the heart, and increase contractility. This article reviews the rationale for and clinical use of diuretics, vasodilators, and inotropes in the management of CHF.