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

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

Volume: 16 Issue: 1

Author(s): Costas Tsioufis*, Georgios Georgiopoulos, Dimitrios Oikonomou, Costas Thomopoulos, Niki Katsiki, Alexandros Kasiakogias, Christina Chrysochoou, Dimitrios Konstantinidis, Theodoros Kalos and Dimitrios Tousoulis

Affiliation:

• First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens,Greece

Keywords: Hypertension, heart failure, preserved ejection fraction, diastolic, dysfunction, blood pressure.

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.

Cite this article as:

Tsioufis Costas *, Georgiopoulos Georgios, Oikonomou Dimitrios , Thomopoulos Costas, Katsiki Niki , Kasiakogias Alexandros , Chrysochoou Christina, Konstantinidis Dimitrios , Kalos Theodoros and Tousoulis Dimitrios , Hypertension and Heart Failure with Preserved Ejection Fraction: Connecting the Dots, Current Vascular Pharmacology 2018; 16 (1) . https://dx.doi.org/10.2174/1570161115666170414120532