Nondihydro- pyridine calcium channel blockers (diltiazem, verapamil) are used to treat hypertension, but they are not recom- mended as routine treatment for patients with HFrEF.8 Amlodipine and felodipine neither improve nor worsen the survival of patients with HF72,73 ; therefore, a dihy- dropyridine group of calcium channel blockers could be used to control hypertension only after other medica- tions have failed. There are few data assessing the ef- ficacy and safety of other medications or of specific combinations of 3 drugs for hypertension in the HF Accordingly, the recommendation of spe- cific multidrug combinations is largely empirical or anec- dotal. Intuitively, it seems most appropriate to continue to combine agents of different mechanisms of action. In that regard, a triple-drug regimen of an ACE inhibitor or ARB, a calcium channel blocker, and a thiazide diuretic is effective and can be well tolerated.74 It should be kept in mind that carvedilol, 1 of the 3 -blockers proven to reduce mortality in HF, is more effective in reducing BP than metoprolol succinate or bisoprolol because of its combined 1 -blocking properties and may be the -blocker of choice among -blockers in patients with HFrEF with refractory hypertension. Evidence with other -blockers with vasodilatory properties such as is very limited, and they are not the -blocker of choice for the treatment of HFrEF according to HF guidelines.8 Experience with older-gen- eration antihypertensive medications such as prazosin, an -receptor blocker,77 or clonidine, a centrally acting is again very limited and precedes the evi- dence with standard HF therapies. Furthermore, studies suggest potential adverse outcomes with these classes of agents that are elaborated below in the Drugs to Avoid in Patients With HF section. 