Treating hypertension in patients with left ventricular dysfunction: Hitting the fairway and avoiding the rough

Samuel W. Joffe, Robert A. Phillips

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Hypertension is a major risk factor in the development of heart failure (HF), yet current guidelines do not specify a target blood pressure (BP) for patients with established systolic or diastolic left ventricular (LV) dysfunction. While no randomized controlled trial (RCT) has been conducted to specify the optimal blood pressure in these patients, numerous trials have demonstrated the benefits of certain classes of medications and treatment strategies in patients with HF. Important factors to consider in treating hypertension in patients with HF include the type of HF (reduced vs. preserved ejection fraction), the etiology (ischemic vs. nonischemic), the severity of symptoms if any, the baseline blood pressure, as well as a wide variety of patient-specific factors. This paper reviews current evidence to address the question, "What should be the blood pressure goal in patients with asymptomatic and symptomatic left ventricular dysfunction?" We suggest a target blood pressure of 120-140/70-90 mm Hg in most cases, with lower pressures generally preferable if tolerated.

Original languageEnglish (US)
Pages (from-to)157-164
Number of pages8
JournalCurrent heart failure reports
Volume10
Issue number2
DOIs
StatePublished - Jun 1 2013

Keywords

  • Aldosterone antagonist
  • Angiotensin converting enzyme inhibitor
  • Angiotensin receptor blocker
  • Beta blocker
  • Diastolic function
  • Diuretic
  • Heart failure
  • Hypertension
  • Systolic function
  • Ventricular dysfunction

ASJC Scopus subject areas

  • Emergency Medicine
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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