Current knowledge of the mechanisms contributing to progression of hea
rt failure suggests that therapies that limit or interfere with the co
nsequences of neurohormonal activation and improve myocardial energeti
cs appear to be most beneficial. Carvedilol, a nonselective P-adrenerg
ic blocker with peripheral vasodilating properties, reduces mortality,
slows progression of disease, and improves quality of life in patient
s with heart failure when added to standard therapy. When administered
according to recommended guidelines, carvedilol is well tolerated. Cl
inical guidelines on the use of carvedilol in heart failure are provid
ed.