Hypertension and Heart Failure with Preserved Ejection Fraction: Connecting the Dots.

By 18 Απριλίου 2017 10 Απριλίου, 2019 Δημοσιεύσεις

Δημοσίευση στις 2017/4/18 στο PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28413968

Tsioufis C, Georgiopoulos G, Oikonomou D, Thomopoulos C, Katsiki N, Kasiakogias A, Chrysochoou C, Konstantinidis D, Kalos T, Tousoulis D.

Abstract

INTRODUCTION:

Heart failure (HF) with preserved ejection fraction (EF) (HFpEF) accounts for approximately 50% of HF cases and its prevalence relative to HF with reduced EF is rising. Hypertension (HT) is the most common co-morbidity in HFpEF patients and it is implicated in both the pathogenesis and the prognosis of the disease. Therefore, HT is a modifiable risk factor of high yield in HFpEF. We reviewed the literature for epidemiologic data supporting the co-aggregation of the two entities as well as patho-physiologic mechanisms linking HT to HFpEF. Most importantly, we focused on treatment options targeting HT as a preventive strategy for delaying the progression of diastolic dysfunction or decreasing the odds for developing HFpEF.

CONCLUSION:

Along this line, we summarized the evidence and efficacy associated with different classes of antihypertensive medications in HFpEF patients. Finally, non-pharmacological approaches, including renal denervation and lifestyle modifications, to achieve optimal blood pressure (BP) control in HFpEF patients are reported. Unfortunately, no specific antihypertensive treatment has established a major survival benefit in this high risk subjects. Until the results of the efficacy of the novel drug LCZ696 (valsartan/ sacubitril) are available, the continuous monitoring and lowering of the BP by pharmacological and non-pharmacological means should be considered the major preventive and treatment strategy in HFpEF patients.

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