Rapid and Intensive Guideline-Directed Medical Therapy for Heart Failure: 5 Core Principles

“It is much better to have all the foundational drugs at a starting dose than to have 1 drug at a maximal dose. You're not covering all the systems you should be covering with 1 drug at a maximal dose. However, you're covering almost everything you want to cover with low starting doses across the board.”

“What we realize now is that the more quickly we can get patients on all four of these drug classes and escalate to target doses or maximally tolerated doses ideally within 3 months, the better the outcome. Unfortunately, right now there is very incomplete realization and recognition of that in clinical practice. So, we are trying to highlight the importance of this to encourage clinicians to be more aggressive in making this happen.”