Question

A 59-year-old with HFrEF (EF 25%) on metoprolol succinate and lisinopril remains NYHA II with stable BP 118/72 and eGFR 45 mL/min/1.73 m². Which medication should be added now to reduce mortality and HF hospitalization?

Accepted Answer

Start an SGLT2 inhibitor (e.g., dapagliflozin 10 mg daily)

Answer

Start spironolactone 25 mg daily

Answer

Increase loop diuretic dose only

Answer

Stop beta-blocker to allow uptitration of ACE inhibitor

Answer

Start digoxin for rate control

Practice question

A 59-year-old with HFrEF (EF 25%) on metoprolol succinate and lisinopril remains NYHA II with stable BP 118/72 and eGFR 45 mL/min/1.73 m². Which medication should be added now to reduce mortality and HF hospitalization?