The overall prevalence of HF ranges from about 1.5% to 4% in developed countries. 2021 and 2022 saw many changes in the guidelines for the management of these patients with HF. One of the key aspect is the moving away from sequential therapy initiation to early and rapid initiation of 4 foundational therapies. Take-home message: Pharmacotherapy remains the corner stone of the management of patients both with HFrEF and HFpEF. Recent years saw the emergence of a completely new class of ( SGLT2 inhibitors) that are now part of the 4 foundational therapies.Personalised management should take into account non-CV comorbidities, namely, iron deficiency, diabetes, AF, and valvular heart disease.