Heart failure & cardiomyopathiesGuideline or statement

Implementation of guideline-directed medical therapy in patients with heart failure and obesity: European Journal of Heart Failure expert consensus document

Eur J Heart FailPublished

  • Expert consensus document

Recommendations

As issued by the authors

  1. Renin-angiotensin system inhibitors (mainly sacubitril-valsartan), MRAs and SGLT2 inhibitors provide consistent benefits across body mass index (BMI) categories, with no major obesity-specific safety concerns (evidence from subgroup analyses of major heart failure (HF) trials)

  2. Data on beta-blockers in obese HF patients remain limited, largely reflecting the older design of pivotal trials

  3. Management should include careful assessment of congestion, acknowledging the limitations of physical examination, and integrate natriuretic peptide measurement and imaging to guide individualised diuretic strategies

Original publication

Implementation of guideline-directed medical therapy in patients with heart failure and obesity: European Journal of Heart Failure expert consensus document. Eur J Heart Fail. Published 4 February 2026. doi:10.1093/ejhf/xuag027

Summarised from the published abstract; every number is checked against it