Recent large-scale clinical trials have provided credible evidence that angiotensin-converting enzyme inhibitors and beta-blockers can prolong the survival in patients with chronic heart failure. Treatment of asymptomatic left ventricular dysfunction is as important as treatment of symptomatic disease. Addition of aldosterone antagonists to angiotensin-converting enzyme inhibitors and beta-blockers may afford further benefits in patients with severe heart failure. If angiotensin-converting enzyme inhibitors or beta-blockers are not tolerated, angiotensin receptor blockers should be considered as the alternative. The present article will review recent advances in treatment of heart failure based on large-scale clinical trials.