|Patient Cohorts||Description||Evidence-Based Recommendations||Risks||Uncertainties|
|African Americans||Self-identified||GDMT||ACEI, ARB, and ARNI: higher risk of angioedema compared with Caucasian patients|
Uncertain risk of hypotension when combining new drugs with HYD/ISDN
|Expected outcomes of ARNI and/or ivabradine in those treated with HYD/ISDN|
|Older adults||≥75 years||Attempt to establish GDMT; however, doses utilized might need to be lower. Device therapy should be carefully considered due to possibly higher risk for complications in older patients||Falls, worsening of renal function, polypharmacy, costs, comorbidity||Efficacy of lower-dose GDMT on outcomes|
|Frail||Meets established frailty criteria (83)||GDMT as tolerated||Uncertain response to GDMT, increase risk for adverse drug reactions||Ability to impact natural history in the frail with HF|
ACEI = angiotensin converting enzyme inhibitors; ARB = angiotensin receptor blockers; ARNI = angiotensin receptor-neprilysin inhibitor; GDMT = guideline-directed medical therapy; HF = heart failure; HYD/ISDN = hydralazine/isosorbide dinitrate.