HEART FAILURE TREATMENT

ACE inhibitor

Beta blocker

ARB

Spironolactone

Cardiovascular risk factors

Lifestyle

HF symptoms + LVEF<40%

Yes

Yes

Hypertension, hyperlipidemia, diabetes to be aggressively managed

Salt restriction, exercise

If ACEI not tolerated

Yes

Yes

Yes

Yes

If beta blocker not tolerated

Yes

Yes

Yes

Yes

If still HF symptoms

Yes

Yes

Yes

Yes

Yes

Severe HF + LVEF<30%

Yes

Yes

Yes

Yes

Yes

Yes