Goals and guidelines for treating hypertension in a patient with heart failure

Douglas S. Lee, Ramachandran S. Vasan

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

Hypertension promotes left ventricular (LV) hypertrophy and myocardial remodeling and is frequently present in patients with systolic or diastolic heart failure. Control of hypertension in both of these settings may attenuate progressive LV hypertrophy and remodeling and improve clinical outcomes. Guidelines for the management of heart failure recommend that hypertension should be treated in all patients with preclinical heart failure as well as in those with heart failure with reduced or preserved LV systolic function. Consistent with national hypertension guidelines, the goal for blood pressure control in hypertensive patients with heart failure is Less than 140/90 mm Hg, but lower targets (< 130/80 mm Hg) may be desirable in those with concomitant diabetes mellitus or renal disease. Angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, and β-adrenoreceptor antagonists are first-line options for hypertension treatment in heart failure. Calcium channel antagonists and the α blocker doxazosin should be avoided. Episodes of recurrent pulmonary edema and hypertension may also indicate underlying severe renovascular disease that may respond to percutaneous renal artery intervention.

Original languageEnglish (US)
Pages (from-to)334-344
Number of pages11
JournalCurrent Treatment Options in Cardiovascular Medicine
Volume8
Issue number4
DOIs
StatePublished - Aug 2006
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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