Table 2.

Pharmacologic Treatments for Heart Failure

Medication	Benefits in patients with HFrEF not on dialysis	Benefits in patients with HFrEF on dialysis
Beta blockers	Carvedilol, metoprolol, and bisoprolol increase survival, improve symptoms and decrease HF hospitalization	Uncertain. Possible improvement in symptoms
ACEi/ARB	Increases survival, improves symptoms, and decreases HF hospitalization	Uncertain
Mineralocorticoid receptor antagonists	Increases survival, improves symptoms, and decreases HF hospitalization	Uncertain
Loop diuretics	Reduces symptom burden	Minimizes weight gains between treatments
Digoxin	May improve symptoms, quality of life, and exercise tolerance in mild to moderate heart failure. No mortality benefit.	Risks likely outweigh any potential benefits.
SGLT2 Inhibitors	Increases survival and decreases HF hospitalization	Not studied; effects would likely need to be independent of kidney function
Angiotensin receptor-neprilysin antagonists	Increases survival and decreases HF hospitalization	Not studied

HFrEF, heart failure with reduced ejection fraction; SGLT2, sodium glucose cotransporter-2; ACEi, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker