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Heart failure management — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsHeart failure managementGPhC CRA

A 58-year-old man presents to the pharmacy with a new prescription for ramipril 1.25 mg once daily. He has a past medical history of type 2 diabetes and has recently been diagnosed with heart failure with reduced ejection fraction (HFrEF). He is already taking bisoprolol 2.5 mg once daily and furosemide 40 mg once daily. He asks why another medication has been added. What is the most appropriate advice to give this patient?

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Correct answer: B — Ramipril has been added as it improves survival in heart failure

ACE inhibitors such as ramipril are a cornerstone of HFrEF management and have been shown to improve survival and reduce hospitalisations. While ramipril does have renoprotective effects in diabetes and can lower blood pressure, its primary indication in this scenario is heart failure with reduced ejection fraction. It does not primarily reduce fluid retention (that is the role of diuretics) and does not significantly slow heart rate.

Reference: NICE CKS Heart Failure; BNF