Which medications for systolic congestive heart failure reduce mortality?

This one is easy. Beta-blockers, angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) and spironolactone. If a patient cannot tolerate ACE inhibitors or ARBs, the combination of hydralazine and nitrates are used — and also reduce mortality, especially in African Americans. Note that digoxin and diuretics do not reduce mortality. They are for symptom relief and to prevent heart failure hospitalization only. For you gunners, the Congestive Heart Failure – Systolic Topic Review provides an in-depth summary from pathophysiology to treatment.