In recent years, the capabilities of modern therapy in improving the prognosis of CHF have changed significantly. This is largely due to introduction of new drugs: angiotensin II receptor antagonists with neprilysin inhibitor and sodium glucose transporter type 2 inhibitors. The purpose of the study was to analyze drug therapy in patients with CHF depending on phenotype, functional class and stage of CHF who presented in hospitals of the Tyumen region between January 2020 and July 2023. We analyzed data on 7303 patients with CHF class I—IV. Mean age was 69.8±9.8 years. Men comprised 40.6% (n=2962). There were different stages and phenotypes of CHF. The compliance of drug therapy with modern clinical guidelines was estimated. No interventions in management of patients were expected. Examination and treatment were completely determined by attending physicians. Despite common use of certain classes of drugs included in optimal drug therapy, there are insufficient prescriptions of quadruple therapy (sodium glucose transporter type 2 inhibitors, angiotensin II receptor antagonists with neprilysin inhibitor, β blockers, mineralocorticoid receptor antagonists) and individual prescriptions (sodium glucose transporter type 2 inhibitors, otensin II receptor antagonists with neprilysin inhibitor). This can affect further course of CHF in this region.