higher than those studied in randomized clinical trials, even if tolerated, are not known to provide incremental bene ts, and are generally not recommended. Strategies for titration are detailed in Figures 2 and 3. Achieving target or maximally tolerated doses of GDMT is the goal of titration. Beta-blocker doses should be adjusted every 2 weeks (43) in a patient with no evidence of decompensated HF and no contraindications to higher doses. Longer time periods may be needed for frail pa- tients or those with marginal hemodynamics, whereas more rapid titration may be reasonable in clinically stable patients without hypotension. Following adjustment, patients should be cautioned that there may be a transient worsening of HF symptoms such as dyspnea, fatigue, erectile dysfunction, or dizziness. An ARNI is the preferred renin-angiotensin inhibitor in the absence of hypotension, electrolyte/renal instability, or prior angioedema on an ACEI or ARB. If administration of an ARNI is not possible, then an ACEI or ARB should be used, barring contraindication. An ARNI/ACEI/ARB may be titrated similarly to beta-blockers with monitoring of renal function, potassium, and blood pressure; more rapid titration is also reasonable in clinically stable patients. For those taking an ARNI, doses can be increased every 2 weeks to allow time for adjustment to the vasodilatory effects of the combined inhibition of the angiotensin receptor and neprilysin while also monitoring renal function, potassium, and especially blood pressure. For optimal titration of an ARNI/ACEI/ARB, lower loop diuretic doses may be necessary to permit titration; in this circumstance, careful attention to potassium concentra- tions is needed, as the kaliuretic effects of loop diuretics may no longer be present, and restriction of supplemental and/or dietary potassium may be necessary. 