▸ Use angiotensin receptor blocker only if an ACE inhibitor is not tolerated. ▸ If already on an ACE inhibitor or beta-blocker when entered into the study, start titration at double their existing dose. ▸ Add furosemide if clinically indicated to control heart failure symptoms (crepitations, ankle swelling, raised jugular venous pressure). ▸ Add spironolactone 25 mg od after titration of ACE (or ARB) plus beta-blocker for patients who are symptomatic on moderate exertion or at rest.
|