Pharmacologic Management of Heart Failure with Preserved Ejection Fraction

Dana Huang; Judy WM Cheng


The Annals of Pharmacotherapy. 2010;44(12):1933-1945. 

In This Article


Much remains to be learned about the appropriate pharmacologic management of patients with HFPEF. HFPEF, which accounts for approximately half of all heart failure cases, carries with it a significant morbidity and mortality burden. As with heart failure with reduced ejection fraction, hypertension is in most cases the predominant contributor to its development and progression. For this reason, antihypertensive treatment, including ACE inhibitors, ARBs, β-blockers, and calcium-channel blockers, have been evaluated and are recommended by both AHA/ACC and the HFSA to be used to control the disease in this patient population, although these agents have not demonstrated significant benefit beyond blood pressure control. Diuretics are recommended for fluid management. Further research into the pathophysiology and mechanisms of HFPEF may contribute to identifying the most optimal agent in managing this disease.