Anything ARNI Can Do, SGLT2i Can Do Better? Debate of Pharmacologic Therapies in HFpEF

Heart Failure with preserved Ejection Fraction (HFpEF) affects between 1.1-5.5% of the general population, with a prevalence of > 10% in older adults (> 75 years of age). Patients with HFpEF suffer from significant morbidity and mortality, however traditional therapies used to manage Heart Failure with reduced Ejection Fraction (HFrEF), have failed to reduce morbidity or mortality in these patients. Recently, mineralocorticoid receptor antagonists (MRA), sodium-glucose cotransporter 2 (SGLT2) inhibitors, and angiotensin receptor blocker neprilysin inhibitors (ARNI) have demonstrated benefits in this population, but limitations in data pose questions regarding application to routine patient care. Further understanding related to patient selection, safe initiation and monitoring, and considerations for shared-decision making discussions (e.g., cost and adherence) is important for adequate therapy optimization, particularly in ambulatory settings and with older adult patients. This session will discuss an initial overview of HFpEF, the "traditional" approach to management, and gaps in patient care; next an interactive discussion of recently evaluated entities for HFpEF, including MRA, ARNI and SGLT2 inhibitors; and finally, a case-based format, allowing both audience and panel of clinical experts to engage in discussion and debate.

This activity is approved for Board Certified Ambulatory Care Pharmacist (BCACP) and Board Certified Geriatric Pharmacist (BCGP) recertification credit.