Do I really need to take these medications?

I’ve recently been diagnosed with heart failure with reduced ejection fraction. I’m only 34. My ejection fractions are 48% Right, 49% left. I’m already on spironolactone for acne, I started that a few months ago but I know it’s good for heart health management as well because it’s a diuretic.

I met with the heart failure doctor after seeing the cardiologist and they want me on both Metoprolol XR & Lisinopril. I’m worried about both short and long term side effects when I’m already incredibly fatigued 24/7 and am on enough medications as it is.

I already have memory problems and I have a low heart rate at rest and low BP. Im feeling really overwhelmed. I don’t really have a reason why I have heart failure. I’m doing a genetic testing and blood work but I’ve felt symptoms pretty much my whole life. They thought it was LVNC at first from my MRI, but the heart failure doc glossed over it and brought up non ischemic cardiomyopathy with reduced EF instead. I feel like I’m pretty borderline for having HF. I’ve lost 95 lbs over the past year and a half which I’m proud of and I’m wondering if I could just make lifestyle changes instead or go on less medication than what they want from me. I honestly don’t know what to do. I’m so anxious to go in these medications for the rest if my life.

-These are some of the questions I’ve come up with since my appt: -

I’m already on Spiro do I really need to take both an ace inhibitor and a beta blocker as well?

Is the only thing wrong my very mildly reduced ejection fractions?

Can I take a newer beta blocker if I absolutely have to? They have less side effects including weight gain. I’m concerned about the side effects especially low heart rate and tiredness when I’m already fatigued everyday and on medications that already affect my ability to function. I’m also concerned about the long term side effects.

Can lifestyle changes help if I do not want to start all medications at this time? Exercise and continuing to lose weight and eat healthier?

34, female, 200.6lbs, 5’6” medications: klonopin, lexapro, elinest, magnesium citrate, Spironolactone, omeprazole.

Thank you.