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Guidelines Directed medical therapy for Heart Failure 

Satyendra Dhar, MD, @DharSaty

#HFrEF #GDMT #sodium-glucosecotransporter-2inhibitors #SGLT2i #reninangiotensinaldosteronesysteminhibitors
AngiotensinReceptorNeprilysinInhibitor #ACEi ... #angiotensinreceptorblockers
ACEI Antihypertensive Dose Comparison. Consider divided (BID) regimen for better pre-dose (trough) BP control for the
ACEI Antihypertensive ... the following ACEIs ... #ACEInhibitor #ACEIs
Lisinopril - ACE inhibitor used for the treatment of hypertension and heart failure. 3rd most prescribed
Lisinopril - ACE ... Prinivil #Qbrelis #ACEI
NSAID vs ACEI/ARB effects on the Kidneys

Remember that NSAIDs and ACEI/ARB therapy have opposing effects on
NSAID vs ACEI/ARB ... that NSAIDs and ACEI ... ACEI/ARB's are often
HFrEF: Guideline Directed Medical Therapy

"Must Be On"
 • ACEI, ARB, or ARNI AND select Beta Blockers
Must Be On" • ACEI ... before increasing ACEI ... Reducing: • ACEI
ARB Approximate Dose Equivalence for BP Lowering and Available Dosage Forms 

VALSARTAN 80-160 mg/day
CANDESARTAN 16 mg/day
ARB #Conversion #AngiotensinReceptorBlocker
Heart Failure (HFrEF) Treatment - GDMT for stage C 

For patients with Heart Failure with REDUCED
initiate them on ACEI ... maximally tolerated ACEI ... Entresto (replacing ACEI
Management of Diabetes Mellitus in Patients With CKD

1. Monitor for changes in BP, serum creatinine, &
the dose of an ACEi ... Continue ACEi or ... Insulin #metformin #ACEi
Distal Renal Tubular Acidosis
Distal RTA is the true Nephrogenic RTA and can be truly divided into
ATPase - AEI ... Uropathy - ACEI
Cough - Diagnostic Schema

Infectious: URTI, LRTI, Bacterial, Viral
Irritant/Exposure: Allergic, Post-infectious, Pneumonitis, ACEi, PTX, Foreign Body
Airway Disease:
, Pneumonitis, ACEi