Primary adrenal insufficiency (PAI) is a well-established risk factor for ischemic heart disease, the most prevalent cause of heart failure. Treatment of patients with heart failure with reduced ejection fraction (HFrEF) and PAI is debatable. Here, we briefly discuss the evidence for treating both conditions. Trials in this particular population are lacking in the literature. In 1983, a single prospective study showed a long-term follow-up of 22 patients with PAI. Seven patients developed HF during a mean follow-up of 30 […]