What is the preferred first-line treatment for chronic heart failure?

The preferred first-line treatment for chronic heart failure is angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors are fundamental in the management of this condition due to their ability to improve symptoms, enhance quality of life, and ultimately prolong survival in patients with chronic heart failure. They work by inhibiting the conversion of angiotensin I to angiotensin II, which results in vasodilation, reduced blood pressure, and decreased afterload on the heart. This diminishes the workload on the heart and helps to alleviate symptoms of heart failure.

Additionally, ACE inhibitors have been shown to reduce morbidity and mortality in heart failure patients with reduced ejection fraction, making them a cornerstone in heart failure management guidelines. They also help to mitigate the remodeling process that occurs in the heart when heart failure progresses, further underscoring their importance in treatment.

In terms of their role within the spectrum of heart failure treatments, while diuretics and beta blockers are also commonly used, diuretics primarily address fluid overload without directly modifying disease progression. Beta blockers, although they are important in the overall management of heart failure and can improve outcomes, are typically introduced after ACE inhibitors. Calcium channel blockers are generally not used as first-line therapy for heart failure, especially not for