The American Heart Association requests that this document be cited as follows: Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Colvin MM, Drazner MH, Filippatos G, Fonarow GC, Givertz MM, Hollenberg SM, Lindenfeld J, Masoudi FA, McBride PE, Peterson PN, Stevenson LW, Westlake C. 2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2016;134:e282 e293. DOI: 10.1161/CIR.0000000000000435. *Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. ACC/AHA Representative. ACP Representative. ISHLT Representative. HFSA Representative. #CHEST Representative. **ACC/AHA Task Force on Performance Measures Representative. AAFP Representative. Heart Failure Focused Update on Pharmacological Therapy CLINICAL STATEMENTS AND GUIDELINES Table of Contents Preamble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e283 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e285 7.3. Stage C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e285 Pharmacological Treatment for Stage C HF With Reduced Ejection Fraction: Recommendations e285 Renin-Angiotensin System Inhibition With Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker or ARNI: Recommendations . . 