Treatment of Heart Failure with Preserved Ejection Fraction (HFpEF)
Heart failure with preserved ejection fraction is managed with an evidence-based regimen directed at relieving congestion, controlling blood pressure, and addressing contributing factors — including fluid retention, hypertension, and atrial fibrillation — as they apply to each patient.
Treatment Goals
Relief of clinical congestion and blood pressure controlled to target.
Treatment Approach
The regimen centres on a sodium-glucose cotransporter 2 inhibitor as a key evidence-based intervention, with further patient-specific steps beyond that — see the full protocol for the complete sequenced approach.
References
DOI: 10.1161/CIR.0000000000001063
- In patients with HFpEF, SGLT2i can be beneficial in decreasing HF hospitalizations and cardiovascular mortality.
- In patients with HF who have fluid retention, diuretics are recommended to relieve congestion, improve symptoms, and prevent worsening HF.
- Patients with HFpEF and hypertension should have medication titrated to attain blood pressure targets in accordance with published clinical practice guidelines to prevent morbidity.
- In patients with HFpEF, management of AF can be useful to improve symptoms.
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