Combination therapy with a diuretic, digoxin, ACE inhibitor, and beta-block
er can help patients with heart failure caused by severe systolic dysfuncti
on feel better and live longer. Especially with ACE inhibitors and beta-blo
ckers, the key to success is starting at low doses and titrating carefully
to proven target doses. The demanding complexity of the four-drug regimen i
s well worth the results.