MediumCardiologyHeart failure with reduced ejection fractionau-racpau-amc
A 66-year-old woman with long-standing hypertension and ischaemic heart disease presents with exertional dyspnoea and ankle swelling. Echocardiography shows a left ventricular ejection fraction of 30%. She is taking perindopril and frusemide but no other heart failure therapies. Her blood pressure is 120/70 mmHg and heart rate 78 bpm in sinus rhythm. According to Australian heart failure guidance, which additional medication class provides a proven mortality benefit and should be added next, assuming no contraindications?