Heart Failure Pharmacotherapy

Pharmacotherapy for heart failure (HF) with reduced ejection fraction (HFrEF) is the foundation of management. The basis of pharmacotherapy for HFrEF includes 4 pillars: beta-blockers, renin angiotensin aldosterone system modulators, mineralocorticoid receptor antagonists, and sodium glucose cotransporter 2 inhibitors. These drug classes collectively reduce mortality, hospitalizations, and can improve functional and clinical status. Additional pharmacotherapy with loop diuretics and sometimes addition of thiazide diuretics at the core can reduce HF symptoms. Contemporary data from recent randomized clinical trials have established a new foundation of successful management of patients with preserved ejection fraction HF.