Numerous clinical trials on neurohormonal modulation have shown that angiotensin-converting enzyme (ACE) inhibition combined with β-adrenergic blockade improves all-cause cardiovascular mortality, sudden cardiac death, and hospitalization rate, including in patients with depressed systolic function. International guidelines now recommend dual neurohormonal inhibition in post–myocardial infarction left ventricular dysfunction and in all symptomatic patients. In patients intolerant to, or with contraindication to, one of these compounds, angioten-sin II receptor blockers (ARBs) are a good alternative. In symptomatic patients, addition of an ARB or/and aldosterone antagonist to the ACE inhibitor and β-blocker can improve the outcome. Other options, such as vasopeptidase inhibitors, endothelin receptor antagonists, and arginine- vaopressin antagonists are currently under evaluation...