A 58-year-old man arrives at the office complaining of progressive fatigue, dyspnea with exertion, and orthopnea. Medical history is significant for hypertension, hyperlipidemia, and a 2 year ago myocardial infarction. The patient claims he hasn't taken his medications in months because he's been "feeling well." The blood pressure is 160/95 mm Hg, and the pulse rate is 94 beats per minute. The physical examination reveals bilateral lung crackles as well as lower extremity edema. The maximal impulse point is shifted toward the axilla, and an S3 is heard. Serum creatinine levels are 0.9 mg/dL, and serum potassium levels are 4.2 mEq/L. After this patient's condition has stabilized, long-term use of which of the following medications will most likely reduce mortality?

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Eductional Objective: Neurohormones (for example, norepinephrine, angiotensin II, and aldosterone) play a significant role in the detrimental cardiac remodeling that occurs in heart failure with reduced ejection fraction. By reducing neurohormonal-mediated cardiac remodeling, ACE inhibitors, angiotensin-receptor blockers, mineralocorticoid receptor antagonists, beta blockers, and angiotensin receptor-neprilysin inhibitors reduce mortality in these patients.

A 58-Year-Old Man Arrives at the Office Complaining of Progressive