Introduction
To date, five pharmacological approaches have been demonstrated to significantly reduce the risk of mortality and prevent hospitalisation for worsening heart failure (HF) in patients with HF with reduced ejection fraction (HFrEF): the combination of a neprilysin inhibitor and an angiotensin-receptor blocker (i.e. sacubitril/valsartan), a beta blocker, a mineralocorticoid-receptor antagonist (MRA) and a sodium-glucose co-transporter 2 (SGLT2) inhibitor. Hereafter, these five agents, which can be prescribed as four pills, will be referred to as the ‘four foundational therapies for HFrEF’.1-11 The combination of these four ther
