Present guidelines strongly recommend treating HFrEF patients with medications proven to relieve symptoms, decrease hospitalizations and improve survival.By reviewing the history of treatments for HFrEF patients, the pharmacological “game changers” are evidence-based betablockers, aldosterone receptor blockers, isosorbide dinitrate/hydralazine and sacubitril/valsartan. To achieve beneficial results as found in clinical trials, HFrEF patients must be beta-blocked, afterload must be advanced, and renal function, potassium and magnesium must be monitored.
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