New insights in treatment for Heart failure

• Many different classes of antihypertensive drugs exist. As hypertension is a huge problem globally, pharmaceutical companies have seen a massive economic market in the development, marketing and promotion of new agents. Until recently, thiazide diuretics and beta-blockers have been regarded as the mainstay of hypertension treatment. Whilst they both have their shortcomings, the fact that they have been tried and tested by time, with large outcome trials, these agents have been advocated as first-line drugs in many previous guidelines.
• The scene has now changed. There is an increasing recognition that beta-blockers are ineffective as firstline agents in the elderly and in Afro-Caribbean patients, partly due to the low renin state in these patients. Certainly, the evidence as to whether betablockers are even effective in reducing end-points in hypertension⁸