Which statement describes guideline-directed medical therapy for HFrEF?

Which statement describes guideline-directed medical therapy for HFrEF?

• A. It excludes SGLT2 inhibitors
• B. It relies only on diuretics
• C. It includes RAAS inhibitors, MRAs, beta blockers, and SGLT2 inhibitors
• D. It recommends nitrates as first-line

Answer: (C)

Guideline-directed medical therapy for HFrEF centers on reducing mortality and hospitalizations by using four key drug classes: RAAS inhibitors (ACE inhibitors or ARBs or ARNIs), beta-blockers, mineralocorticoid receptor antagonists, and SGLT2 inhibitors. These classes have strong trial evidence showing survival benefits and fewer hospitalizations, and SGLT2 inhibitors are now recommended as part of standard therapy even in patients without diabetes. Diuretics help with symptoms of fluid overload but do not improve survival, so they are not considered the foundational GDMT. Nitrates with hydralazine can be beneficial in select patients but are not first-line for GDMT in the general HFrEF population.

Guideline-directed medical therapy for HFrEF centers on reducing mortality and hospitalizations by using four key drug classes: RAAS inhibitors (ACE inhibitors or ARBs or ARNIs), beta-blockers, mineralocorticoid receptor antagonists, and SGLT2 inhibitors. These classes have strong trial evidence showing survival benefits and fewer hospitalizations, and SGLT2 inhibitors are now recommended as part of standard therapy even in patients without diabetes. Diuretics help with symptoms of fluid overload but do not improve survival, so they are not considered the foundational GDMT. Nitrates with hydralazine can be beneficial in select patients but are not first-line for GDMT in the general HFrEF population.