Advise patients with heart failure to limit salt to 2 g sodium and fluid intake to 2 quarts daily.
Use ACE inhibitors in all patients with heart failure regardless of functional class except in patients with a history of angioedema; use ARBs instead in patients intolerant of ACE inhibitors.
Use β-blockers in patients with all NYHA classes of heart failure.
Use hydralazine combined with nitrates as an alternative to ACE inhibitors or ARBs in patients intolerant to both, and consider adding it to standard therapy in African-American patients with heart failure.
Use low doses of an aldosterone antagonist in patients with NYHA class III to IV heart failure on ACE inhibitors and β-blockers.
Use loop diuretics to control volume overload and improve the functional capacity of patients with heart failure.
Evaluate patients with heart failure and ventricular arrhythmias, syncope, sudden cardiac death, or EF < 35% for ICD placement.
Consider cardiac resynchronization therapy for patients with NYHA class III or IV heart failure, EF <35% and prolonged QRS duration.
Treat patients with a normal ejection fraction and signs and symptoms of heart failure for diastolic dysfunction.