Aldosterone antagonists

These drugs block the action of the hormone aldosterone, which promotes salt and fluid retention and may have direct adverse effects on the heart.

Both are potassium-sparing diuretics and improve survival and reduce hospitalizations.

Angiotensin-converting enzyme (ACE) inhibitors

ACE inhibitors cause blood vessels to widen (dilate), thus decreasing the amount of work the heart has to do.

They may also have direct beneficial effects on the heart.

These drugs are the mainstay of heart failure treatment.

They reduce symptoms and the need for hospitalization, and they prolong life.

They may be used in people who cannot take an ACE inhibitor.

Angiotensin receptor/neprilysin inhibitor

The combination drug may be given to people who have systolic heart failure with mild or moderate symptoms. In these people, this combination drug prolongs life better than an ACE inhibitor used alone.

Beta-blockers

Beta-blockers slow the heart rate and block excessive stimulation of the heart.

These drugs are usually used with ACE inhibitors and provide an added benefit.

They may temporarily worsen symptoms but result in long-term improvement in heart function.

Cardiac glycoside

Guanylate cyclase stimulator

Causes widening of the artery transporting blood from the right side of the heart to the lungs

Loop diuretics

These diuretics help the kidneys eliminate salt and water, thus decreasing the volume of fluid in the bloodstream.

Potassium-sparing diuretics

Because these diuretics prevent potassium loss, they may be given in addition to thiazide or loop diuretics, which cause potassium to be lost.

Sinus node inhibitor

Sodium-glucose cotransporter-2 inhibitors

These drugs for diabetes also have beneficial effects in heart failure whether or not people have diabetes

Typically are not used in people who have low blood pressure or poor kidney function

Typically are not used in people who have low blood pressure or poor kidney function

Thiazide and thiazide-like diuretics

The effects of these diuretics are similar to loop diuretics. The two types of diuretics are particularly effective when used together.

Opioid

Careful supervision is necessary.

Vasodilators

Vasodilators cause blood vessels to dilate.