Pharmacotherapy of heart failure: A narrative review of contemporary guideline-directed drug therapy

Heart failure remains one of the most common, costly, and lethal cardiovascular syndromes worldwide, affecting more than 64 million people globally and carrying a prognosis that is often worse than many forms of cancer. Over the past four decades, pharmacological management has evolved from a purely symptomatic, diuretic centred approach into a sophisticated, evidence-driven strategy that targets the neurohormonal maladaptation underlying the disease. This narrative review summarizes the pharmacotherapy of heart failure with a focus on guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF).