Table 2. Effects and typical side effects of the various heart failure drugs*¹.

Drugs	Overall mortality HR [95% CI]	NNT for mortality (standardized for 36 months)	Heart failure- related hospitalizations HR [95% CI]	Typical side effects	Typical active substances	Initial daily dose	Target daily dose
ACE inhibitors (e25, 38)	0.84 [0.67; 1.01]	26	0.52 [0.32; 0.76]	Impaired renal function, hyperkalemia, hypotension, cough, angioedema	Captopril	3 × 6.25 mg	3 × 50 mg
					Enalapril	2 × 2.5 mg	2 × 10–20 mg
					Lisinopril	1 × 2.5–5.0	1 × 20–35 mg
					Ramipril	1 × 2.5 mg	1 × 10 mg
					Trandolapril	1 × 0.5 mg	1 × 4 mg
Angiotensin receptor blocker (e25, 38)	0.89 [0.61; 1.27]		0.53 [0.26; 1.03]	Impaired renal function, hyperkalemia, hypotension	Candesartan	1 × 4–8 mg	1 × 32 mg
					Losartan	1 × 50 mg	1 × 150 mg
					Valsartan	2 × 40 mg	2 × 160 mg
Beta-blockers (e25, 38)	0.58 [0.34; 0.95]	9	0.45 [0.13; 1.39]	Bradycardia, hypotension, impaired peripheral perfusion, bronchoconstriction	Bisoprolol	1 × 1.25 mg	1 × 10 mg
					Carvedilol	2 × 3.125 mg	2 × 25 mg
					Metoprolol succinate	1 × 12.5–25 mg	1 × 200 mg
					Nebivolol	1 × 1.25 mg	1 × 10 mg
MRA (e25, 38)	0.58 [0.36; 0.90]*1	6	0.36 [0.12; 0.96]*1	Hyperkalemia, impaired renal function, hypotension (primarily spironolactone); gynecomastia, impotence, menstrual disorders (spironolactone)	Eplerenone	1 × 25 mg	1 × 50 mg
					Spironolactone	1 × 25 mg	1 × 50 mg
If  channel blockers (e24)	0.96 [0.87; 1.05]	NA	0.81 [0.73; 0.89]	Symptomatic bradycardia, impaired vision (phosphenes, blurred vision), atrial fibrillation	Ivabradine	2 × 5 mg	2 × 7.5 mg
ARNI (10, e26)	0.84 [0.76; 0.93]*2	35*2	0.79 [0.71; 0.89]*2	Impaired renal function, hyperkalemia, hypotension, angioedema	Sacubitril/ valsartan	2 × 49/51 mg	2 × 97/103 mg
SGLT2 inhibitors (21)*3	0.83 [0.71; 0.97]	22	0.70 [0.59; 0.83]	Genital infections, urinary tract infections, hypoglycemia (when combined with sulfonylureas or insulin), diabetic ketoacidosis, dysuria, polyuria, volume depletion	Dapagliflozin	1 × 10 mg	–
					Empagliflozin	1 ×10 mg (increasing if appropriate to 1 × 25 mg)

*¹ In combination with ACE inhibitors, *²vs ACE inhibitors, *³the mentioned side effects relate to the results of the DAPA-HF study (dapagliflozin vs. placebo in addition to an existing pharmacological heart failure treatment); modified from (10, 13, 21, e24– e26, 38)

ARNI, angiotensin receptor neprilysin inhibitors; CI, confidence interval; HR, hazard ratio; MRA, mineralocorticoid receptor antagonists, NNT, number needed to treat; SGLT2, sodium-glucose linked transporter 2