Consistent effects of empagliflozin were observed across subgroups de- fined by baseline characteristics, including patients with versus without HF. But among patients with HF, improve- ment in clinical outcomes including reductions in mortal- ity, cardiovascular death, or HF hospitalizations did not reach significance. There was no measure of LVEF or natriuretic peptides in the trial. Currently, other ongoing large, cardiovascular outcome trials of several sodium- glucose cotransporter 2 inhibitors (and other novel glucose-lowering medications with potentially favorable cardiovascular effects such as glucagon-like peptide-1 agonists) will provide additional valuable data, especially in patients with established HF, in this regard. Recommendations Harmonized With Existing Guidelines for the Recognition and Treatment of Patients With HF With Diabetes Mellitus See Tables 5 through 7 for summary of these recom- mendations. Stage A HF 1. For patients with diabetes mellitus (who are all at high risk for developing HF), blood sugar should be controlled in accordance with contemporary guidelines (Class I; Level of Evidence C).8 2. ACE inhibitors can be useful to prevent HF in patients at high risk for developing HF who have a history of atherosclerotic vascular Bozkurt et al disease, diabetes mellitus, or hypertension with associated cardiovascular risk factors (Class IIa; Level of Evidence A). 3. ARBs can be useful to prevent HF in patients at high risk for developing HF who have a history of atherosclerotic vascular disease, diabetes mellitus, or hypertension with asso- ciated cardiovascular risk factors (Class IIa; Level of Evidence B). 