Question

A 72-year-old man with a history of heart failure with reduced ejection fraction (LVEF 30%), hypertension and type 2 diabetes is clinically euvolaemic on examination. Current medications include ramipril, bisoprolol and furosemide. His blood pressure is 120/70 mm Hg, creatinine is 95 µmol/L and potassium is 4.5 mmol/L. According to Canadian heart failure guidelines, which medication class should be added next to reduce mortality?

Accepted Answer

A mineralocorticoid receptor antagonist (e.g., spironolactone).

Answer

A non-dihydropyridine calcium channel blocker (e.g., diltiazem).

Answer

A thiazide diuretic (e.g., hydrochlorothiazide).

Answer

A short-acting nitrate (e.g., isosorbide dinitrate alone).

Answer

A loop diuretic at higher dose (e.g., increase furosemide).

Practice question