Which class of medications is typically used for heart failure with reduced ejection fraction?

Heart failure with reduced ejection fraction (HFrEF) is a clinical syndrome often characterized by the heart's inability to pump effectively due to a weakened muscle, resulting in insufficient blood flow to meet the body's needs. The goal of pharmacological therapy in this condition is to improve symptoms, enhance quality of life, and reduce mortality.

Angiotensin-converting enzyme (ACE) inhibitors play a crucial role in the management of HFrEF. They work by blocking the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. By reducing levels of angiotensin II, ACE inhibitors decrease vascular resistance, leading to lower blood pressure and, consequently, reduced strain on the heart. This reduction in preload and afterload helps improve cardiac output and facilitates better tissue perfusion.

Additionally, ACE inhibitors have been shown to have favorable effects on neurohormonal activation, which is often upregulated in heart failure. By mitigating the effects of the renin-angiotensin-aldosterone system (RAAS), they minimize fluid retention and heart remodeling, contributing to improved clinical outcomes.

While other classes of medications, such as beta-blockers and diuretics, are also important components in the management of heart failure, ACE