We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Drug Therapy for Acute and Chronic Heart Failure with Preserved Ejection Fraction with Hypertension: A State-of-the-Art Review.
- Authors
Hiraiwa, Hiroaki; Okumura, Takahiro; Murohara, Toyoaki
- Abstract
In this comprehensive state-of-the-art review, we provide an evidence-based analysis of current drug therapies for patients with heart failure with preserved ejection fraction (HFpEF) in the acute and chronic phases with concurrent hypertension. Additionally, we explore the latest developments and emerging evidence on the efficacy, safety, and clinical outcomes of common and novel drug treatments in the management of HFpEF with concurrent hypertension. During the acute phase of HFpEF, intravenous diuretics, mineralocorticoid receptor antagonists (MRAs), and vasodilators are pivotal, while in the chronic phase, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have proven effective in enhancing clinical outcomes. However, the use of calcium channel blockers in HFpEF with hypertension should be approached with caution, owing to their potential negative inotropic effects. We also explored emerging drug therapies for HFpEF, such as sodium–glucose co-transporter 2 (SGLT2) inhibitors, angiotensin receptor–neprilysin inhibitor (ARNI), soluble guanylate cyclase (sGC) stimulators, novel MRAs, and ivabradine. Notably, SGLT2 inhibitors have shown promise in reducing heart failure hospitalizations and cardiovascular mortality in patients with HFpEF, regardless of their diabetic status. Additionally, ARNI and sGC stimulators have demonstrated potential in improving symptoms, functional capacity, and quality of life. Nonetheless, additional research is necessary to pinpoint optimal treatment strategies for HFpEF with concurrent hypertension. Furthermore, long-term studies are essential to assess the durability and sustained benefits of emerging drug therapies. Identification of novel targets and mechanisms underlying HFpEF pathophysiology will pave the way for innovative drug development approaches in the management of HFpEF with concurrent hypertension.
- Subjects
HETEROCYCLIC compounds; ACUTE diseases; VENTRICULAR ejection fraction; PATIENT safety; VASODILATORS; HYPERTENSION; ACE inhibitors; HEART failure; DIURETICS; CALCIUM antagonists; CHRONIC diseases; INTRAVENOUS therapy; ALDOSTERONE antagonists; DRUG efficacy; ADRENERGIC beta blockers; SODIUM-glucose cotransporter 2 inhibitors
- Publication
American Journal of Cardiovascular Drugs, 2024, Vol 24, Issue 3, p343
- ISSN
1175-3277
- Publication type
Article
- DOI
10.1007/s40256-024-00641-9