[Pharmacological management of chronic heart failure].

Pharmacological management of chronic heart failure. Chronic heart failure (CHF) is a highly prevalent syndrome associated with a high mortality rate and with lengthy and recurrent hospitalizations. In heart failure with reduced ejection fraction (HFrEF), six classes have shown beneficial effects on morbi-mortality : angiotensin converting enzyme inhibitors, beta blockers, antagonists of mineralocorticoid receptors, antagonists of angiotensin-II receptors, ivabradine and sacubitril-valsartan. The strategy of management of HFrEF is well defined whereas in HF with preserved ejection fraction (HFpEF) no treatment has convincingly demonstrated any benefit on mortality but spironolactone reduces the rate of HF hospitalizations. Disease modifying drugs have induced a reduction in mortality related to heart failure, whereas the burden of hospitalizations and rehospitalizations remains poorly controlled.