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Medicines for Heart Failure - Topic Overview

How do medicines relieve my symptoms?

Medicines for heart failure help relieve the symptoms of heart failure by:

  • Removing excess fluid from the body. The class of medicines known as diuretics acts principally to rid the body of excess fluid.
  • Improving the ability of the heart to pump more effectively. Another type of medicine, digoxin, works primarily by increasing the strength of the contraction of the heart.
  • Preventing further injury to the heart. A class of medicines known as angiotensin-converting enzyme (ACE) inhibitors acts both by improving the efficiency of pumping and by preventing further damage to the heart.

How do medicines prolong my survival?

Several classes of medicines have been proven to increase the life span of people with heart failure. These include:

  • ACE inhibitors.
  • ARBs (angiotensin II receptor blockers).
  • Beta-blockers.
  • Spironolactone, a diuretic. (Other diuretics can improve symptoms but do not improve survival.)

The exact mechanism by which these medicines prolong survival is not entirely clear. Each medicine might have several beneficial effects for people with heart failure. In terms of prolonging survival, the most important effects may be the ability of these drugs to prevent both lethal abnormal heart rhythms and their ability to limit ongoing damage to the heart.

What types of medicines are used to treat heart failure?

There are many medicines that are designed to control symptoms of heart failure, improve heart function, and enhance chances of long-term survival. These medicines can be grouped together into classes of drugs that work in similar ways to treat heart failure. The three classes of medicines that have been proved to have the greatest benefit for people with heart failure are summarized in the following table.

Medicines for heart failure

Drug class

How it works



Diuretics stimulate your kidneys to get rid of extra fluid from your body. Since many of the symptoms of heart failure are caused by increased fluid in the body, diuretics can provide relief from some of the most uncomfortable symptoms.

Spironolactone also blocks the activity of a hormone called aldosterone that may contribute to worsening heart function.

ACE inhibitors

Angiotensin-converting enzyme inhibitors block the production of angiotensin II, a hormone that makes heart failure worse by leading to salt and water retention, which increases blood pressure.

  • Captopril
  • Lisinopril
  • Enalapril


Angiotensin II receptor blockers make it hard for the hormone angiotensin to work. This hormone causes blood vessels to narrow. ARBs help the blood vessels relax and widen, which reduces blood pressure. ARBs also increase the release of water and sodium to the urine, which lowers blood pressure too.


Beta-blockers decrease the strength with which your heart contracts and beats. In the long term, beta-blockers appear to help prevent changes in the heart that make heart function worse.

  • Metoprolol
  • Carvedilol
  • Bisoprolol

WebMD Medical Reference from Healthwise

Last Updated: August 09, 2010
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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