This protocol addresses adults who self-identify as African American with heart failure with reduced ejection fraction (LVEF ≤40%) and NYHA class III to IV symptoms who are already receiving optimal medical therapy.
The regimen involves continuing optimised guideline-directed medical therapy, titrated as tolerated, with additional therapy specifically indicated for this patient population.
DOI: 10.1161/CIR.0000000000001063
For patients self-identified as African American with NYHA class III-IV HFrEF who are receiving optimal medical therapy, the combination of hydralazine and isosorbide dinitrate is recommended to improve symptoms and reduce morbidity and mortality.
Thus, the combination of hydralazine and isosorbide dinitrate is appropriate for African Americans with HFrEF who remain symptomatic despite concomitant use of ACEi (or ARB), beta blockers, and MRA.
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