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Heart failure optimisation — GPhC CRA MCQ

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HardCardiovascular TherapeuticsHeart failure optimisationGPhC CRA

A patient has symptomatic heart failure with preserved ejection fraction, eGFR 54 mL/min/1.73 m² and potassium 4.2 mmol/L. Which disease-modifying combination is now considered by NICE?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: CA mineralocorticoid-receptor antagonist plus an SGLT2 inhibitor

NICE updated NG106 in 2025 to consider an MRA and SGLT2 inhibitor for HFpEF. Diuretics still manage congestion and comorbidities require treatment, but neither replaces the disease-modifying combination. Renal function, potassium, blood pressure and adverse effects guide introduction.

Reference: NICE NG106: chronic heart failure — recommendations: https://www.nice.org.uk/guidance/ng106/chapter/recommendations