AKT-5497

A 72-year-old man with treated cardiac failure comes to the GP surgery for a three month review after a recent admission for medication stabilisation.

He is currently taking ramipril 10 mg, bisoprolol 10 mg and 40 mg of furosemide. On examination his BP is 122/72, his pulse is 75 and regular. There are sparse crackles at both lung bases but there are no signs of peripheral oedema.

Haemoglobin 127 g/L (115-165)
White cells 6.9 ×109/L (4-11)
Platelets 208 ×109/L (150-400)
Sodium 139 mmol/L (135-146)
Potassium 4.1 mmol/L (3.5-5)
Creatinine 149 μmol/L (79-118)
BNP 230 pg/mL (<100)
Ejection fraction 38%

Which of the following is the NICE recommended next step?