Although beta-blockers have been shown to improve outcomes in patients with systolic dysfunction, their efficacy in patients of African ancestry has been questioned.27 A GRK5 polymorphism seen in black patients actually gives genetic beta-blockade and improves survival in African patients.28 A meta-analysis also confirmed no significant overall benefit of beta-blockade in black patients with NYHA class III/IV heart failure.29 The gene discussed is GRK5; the disease is heart failure.