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Moderate"MRAs (spironolactone/eplerenone) improve survival in HFrEF if renal function and potassium allow. Thiazides or CCBs don't confer mortality benefit; ivabradine is for select high‑HR patients after foundational therapy."Heart Failure with Reduced Ejection Fraction"moderate"

A 59-year-old with HFrEF (LVEF 28%) on ACE inhibitor and beta-blocker remains symptomatic. Per 2022 HF guideline, which agent improves survival and should be added (if K+ ≤5.0 and eGFR ≥30)?

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