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Lee DS, Vasan RS. Goals and guidelines for treating hypertension in a patient with heart failure. Curr Treat Options Cardiovasc Med. 2006;8(4):334-44doi: 10.1007/s11936-006-0054-2.
Lee, D. S., & Vasan, R. S. (2006). Goals and guidelines for treating hypertension in a patient with heart failure. Current treatment options in cardiovascular medicine, 8(4), 334-44. https://doi.org/10.1007/s11936-006-0054-2
Lee, Douglas S, and Vasan, Ramachandran S. "Goals and guidelines for treating hypertension in a patient with heart failure." Current treatment options in cardiovascular medicine vol. 8,4 (2006): 334-44. doi: https://doi.org/10.1007/s11936-006-0054-2
Lee DS, Vasan RS. Goals and guidelines for treating hypertension in a patient with heart failure. Curr Treat Options Cardiovasc Med. 2006 Aug;8(4):334-44. doi: 10.1007/s11936-006-0054-2. PMID: 17038273.
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Curr Treat Options Cardiovasc Med. 2006 Aug;8(4):334-44. doi: 10.1007/s11936-006-0054-2.

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

Current treatment options in cardiovascular medicine

Douglas S Lee, Ramachandran S Vasan

Affiliations

  1. Framingham Heart Study, 73 Mt. Wayte Avenue, Suite 2, Framingham, MA 01702-5827, USA.

PMID: 17038273 DOI: 10.1007/s11936-006-0054-2

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 beta-adrenoreceptor antagonists are first-line options for hypertension treatment in heart failure. Calcium channel antagonists and the alpha 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.

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