Heart Failure Medications: A Physician’s Guide for Optimization

The 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure recommends quadruple therapy with an angiotensin receptor-neurolysin inhibitor (ARNI), beta blocker, mineralocorticoid receptor antagonist (MRA), and sodium-glucose cotransporter 2 (SGLT2) inhibitor for patients with heart failure with reduced ejection fraction (HFrEF). The article reviews the categories of heart failure, mechanisms, indications, contraindications, and adverse effects of these medications. It also highlights the classifications of heart failure, based on stages and New York Heart Association (NYHA) categories, and the benefits demonstrated in clinical trials, including reducing mortality risk and improving symptoms. The use of these medications has been shown to lower hospitalization and mortality rates in heart failure patients.

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