Treatment Guidelines from The Medical Letter
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121
Drugs for Chronic Heart Failure
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RECOMMENDATIONS - Unless there is a specific contraindication, all patients with heart failure and systolic dysfunction (LVEF ≤40%) should take both an ACE inhibitor and a beta blocker, and if volume overloaded, a diuretic as well. An angiotensin receptor blocker (ARB) is recommended for patients who cannot tolerate an ACE inhibitor. Addition of an aldosterone antagonist can be beneficial for patients with symptomatic heart failure or for patients with left ventricular dysfunction after a myocardial infarction. A combination of hydralazine and isosorbide dinitrate added to standard therapy has been effective in African-American patients with class III-IV heart failure. Digoxin can decrease symptoms and lower the rate of hospitalization for heart failure, but does not decrease mortality. There is no evidence that any drug improves clinical outcomes in patients with heart failure with preserved systolic function.

Chronic systolic ... more      

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Title: Drugs for Chronic Heart Failure
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