A 70-year-old patient with acute systolic HF denies functional limitations and is able to walk five blocks before tiring. Which medication is first-line therapy for this patient?

Lisinopril is recognized as a first-line medication for the treatment of acute systolic heart failure, particularly in patients like the one described. Angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril, are essential in managing heart failure due to their ability to reduce mortality and morbidity. They work by lowering blood pressure, decreasing the workload on the heart, and improving cardiac output.

In the context of a 70-year-old patient with acute systolic heart failure, even though they deny functional limitations and can walk a certain distance, it is critical to manage the underlying symptoms and prevent further complications. Lisinopril helps in this regard by dilating blood vessels and improving blood flow, which can alleviate symptoms associated with heart failure.

Other choices, such as beta-blockers, digoxin, and furosemide, all have roles in the management of heart failure, but they are generally not considered first-line therapy for acute settings compared to ACE inhibitors. Beta-blockers are often used for long-term management and may be introduced gradually in stable patients. Digoxin is less favored unless patients have concurrent atrial fibrillation or other specific conditions. Furosemide is a diuretic used for symptomatic treatment of fluid