| ACE inhibitors5–7 | A | If tolerated, should be the initial baseline treatment in all patients with heart failure, regardless of NYHA class |
| ARBs8–10 | A | Benefits similar to those of ACE inhibitors; useful in patients who cannot tolerate ACE inhibitors |
| Aerobic exercise26 | A | Decreases hospitalization and improves quality of life |
| Comprehensive, multidisciplinary outpatient follow-up27,28 | A | Decreases hospitalization for heart failure |
| Beta blockers11–16 | A | Beneficial in most patients with heart failure; usually added to ACE inhibitors or ARBs |
| | May be useful if there are concomitant tachydysrhythmias following myocardial infarction |
| Carvedilol (Coreg)17 | A | Proven benefit in moderate to severe heart failure (i.e., NYHA classes II to IV); benefit in severe heart failure (i.e., NYHA classes III to IV) where other beta blockers do not have proven benefit |
| Spironolactone (Aldactone)18 | A | Proven benefit in severe heart failure (i.e., NYHA classes III or IV); severe hyperkalemia is an important safety concern. |
| Eplerenone (Inspra)19 | A | Reduces mortality in patients with left ventricular dysfunction following myocardial infarction |
| Hydralazine (Apresoline) plus isosorbide dinitrate (Sorbitrate)19,20 | A | Combination beneficial in all classes of heart failure. Use is limited by poor tolerability. |
| Digoxin21–24 | B | May reduce the number of hospitalizations for heart failure; no mortality benefit; narrow therapeutic window |
| Diuretics4,25 | C | Useful for control of symptoms and fluid and sodium levels |
| Dietary sodium restriction4,27 | C | Recommended as standard practice, but there are no morbidity or mortality data from randomized controlled trials |