Medications

Medications are an important part of treating heart failure. Your doctor may recommend one or a combination of the following:

Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) relax your blood vessels and reduce strain on your heart and improve blood flow. They also lower blood pressure.

Angiotensin receptor-neprilysin inhibitor (ARNI) is a combination of an ARB and a medicine that inhibits the production of neprilysin, an enzyme. This enzyme breaks down natural substances in the body that widen blood vessels and reduce sodium retention. The effect is to lower blood pressure and decrease strain on the heart.

Beta blockers can slow a rapid heart rate and lower your blood pressure.

Digoxin slows heart rate and strengthens heart muscle contractions to pump more blood. It can make you feel better.

Diuretics, also called water or fluid pills, help keep fluid from building up in your body or lungs – they will also make you urinate more often.

Mineralocorticoid receptor antagonists help the body to get rid of salt and water through urine. This lowers the volume of blood that the heart must pump.

Nitrates and hydralazine is a combination of drugs that has been shown to improve outcomes in African American patients. It is often used if someone is allergic to or can't take ACE inhibitors or ARBs.

Sinoatrial node modulator (ivabradine) is a drug used with beta blockers when they cannot lower your heart rate enough. It helps reduce the amount of oxygen your heart needs and the amount of work your heart does to pump blood through the body.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors were originally used to treat diabetes. These medicines have clear benefits for people with heart failure, including fewer heart-related deaths and hospitalizations.

Soluble guanylase cyclase stimulator (vericiguat) can result in beneficial relaxation of blood vessels and decrease strain on the heart. This medication may result in fewer heart-related deaths and hospitalizations in people with heart failure who have recently been hospitalized and are already on optimal medical therapy with ARNI, beta blockers, aldosterone antagonists, and SGLT2 inhibitors.