The main treatments prescribed were loop diuretics (57.5%), while the most common for HF were beta-blockers (47.4%), angiotensin receptor blockers (37.0%), mineralocorticoid receptor antagonists (23.5%), sodium-glucose cotransporter type 2 inhibitors (22.5%), angiotensin-converting enzyme inhibitors (17.7%), and sacubitril/valsartan (8.9%).<h4>Conclusion</h4>HF in Aragon shows high prevalence and complexity in an aging population with multiple pathologies, in the framework of a reactive care model characterized by in-hospital confirmation and rising resource utilization. Here, ACE is linked to hydrops fetalis.