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In addition to a healthy lifestyle, medications are an important part of care required to help you live longer and better with heart failure. Once you start to experience symptoms from heart failure when the left ventricle function is impaired (known as heart failure with reduced ejection fraction, or HFrEF), four key types of medication are recommended to be given at the same time for the best results.

These are:

• Medications that reduce strain on the heart and improve blood flow by lowering blood pressure and reducing neurohormonal activation, preferentially sacubitril/valsartan (Entresto) or, if not feasible, then an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB)

• Beta-blockers, which block the action of stress hormones like adrenaline in certain parts of the body to help control blood pressure, heart rate, and more

• Sodium-glucose cotransporter 2 (SGLT2) inhibitors, which were originally designed to treat diabetes but have been shown to reduce the risk of death from heart-related causes and lessen the risk of worsening heart failure

• Mineralocorticoid receptor antagonists to reduce fluid retention that strains the heart and can make it difficult to breathe

For heart failure with preserved ejection fraction (HFpEF), SGLT2 inhibitors are also strongly recommended, while the other drugs can also be considered but typically have a bigger benefit when the ejection fraction is lower.

Other commonly used medications to treat or prevent conditions that may occur alongside heart failure include drugs to control the rate or rhythm of the heartbeat and blood thinners to reduce the risk of blood clots.

Sticking to the regimen of medications you've planned with your healthcare team is vital. In one , heart failure patients who skipped 20% or more of their pills were twice as likely to die or have a heart failure hospitalization over the course of about 1 year.

Before stopping any medications on your own or skipping doses to save money, talk with your doctor or another member of the healthcare team. They may be able to suggest strategies to help reduce side effects or make your medication regimen more affordable.

Practical steps can also help you remember to take your medications on time every day, such as pillboxes and smartphone app reminders. Scheduling all your refills at the pharmacy for the same time each month or using a mail order pharmacy to provide a 90-day supply of your medications might also help reduce barriers.

Read previous installments in this series:

For Your Patients: What is Heart Failure?

For Your Patients: How Is Heart Failure Diagnosed?

For Your Patients: Getting the Most From Heart Failure Visits

For Your Patients: Self-Care for Heart Failure

For Your Patients: What to Expect From Cardiac Rehabilitation

For Your Patients: Managing Heart Failure With Other Chronic Conditions

For Your Patients: Heart Failure Device Therapy

"Medical Journeys" is a set of clinical resources reviewed by doctors, meant for physicians and other healthcare professionals as well as the patients they serve. Each episode of this journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.