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Guidelines Directed medical therapy for Heart Failure 

Satyendra Dhar, MD, @DharSaty

#HFrEF #GDMT #sodium-glucosecotransporter-2inhibitors #SGLT2i #reninangiotensinaldosteronesysteminhibitors
AngiotensinReceptorNeprilysinInhibitor #ACEi ... ARNI #PARADIGM-HF ... MineralocorticoidReceptorAntagonist #LoopDiuretic
ACEI Antihypertensive Dose Comparison. Consider divided (BID) regimen for better pre-dose (trough) BP control for the
ACEI Antihypertensive ... the following ACEIs ... #ACEInhibitor #ACEIs
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 ... #medications #chf
Stages in the development of HF and recommended therapy by stage. ACEI indicates angiotensin-converting enzyme inhibitor;
development of HF ... ACEI indicates angiotensin-converting ... medical therapy; HF ... #CHF #Congestive
Lisinopril - ACE inhibitor used for the treatment of hypertension and heart failure. 3rd most prescribed
Lisinopril - ACE ... Prinivil #Qbrelis #ACEI
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 ... /ambcarerx #CHF ... #sCHF #HeartFailure
Cough - Diagnostic Schema

Infectious: URTI, LRTI, Bacterial, Viral
Irritant/Exposure: Allergic, Post-infectious, Pneumonitis, ACEi, PTX, Foreign Body
Airway Disease:
, Pneumonitis, ACEi ... GERD, Dysphagia, CHF
Heart Failure with Reduced Ejection Fraction (HFrEF) - Guideline Directed Medical Therapy
 • Beta-blocker
 • ACE,
Beta-blocker • ACE ... Heart #Failure #CHF
Heart Failure with Reduced Ejection Fraction (HFrEF) - Guideline Directed Medical Therapy - Initiation Strategies

 •
Stepwise Approach: ACE ... Heart #Failure #CHF
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