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MediumCardiologyChronic Heart Failure (HFrEF)ukmlamrcgp aktpanemrcp part 1prescribing safety assessment

A 62-year-old man with known heart failure (NYHA Class II, LVEF 35%) is managed with ramipril 10mg OD, bisoprolol 5mg OD, and furosemide 40mg OD. He remains symptomatic with mild ankle swelling and breathlessness on moderate exertion. His BP is 120/75 mmHg, HR 65 bpm, and eGFR is 55 ml/min/1.73m². According to NICE NG106, which medication should be added next to improve prognosis?

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