MediumCardiologyHeart failure with reduced ejection fractionau-amcau-racp
A 72-year-old man with long-standing hypertension and ischaemic heart disease presents with exertional dyspnoea and ankle swelling. Echocardiography shows left ventricular ejection fraction of 30% with global hypokinesis. He is euvolaemic after diuretic optimisation. Which medication has the strongest evidence for improving survival in this setting and should be part of first-line disease-modifying therapy?