Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jun;10(1):9-25.
doi: 10.1007/s40119-020-00203-5. Epub 2020 Nov 17.

Contemporary Strategies to Manage High Blood Pressure in Patients with Coexistent Resistant Hypertension and Heart Failure With Reduced Ejection Fraction

Katherine Lang  1 , Erik H Van Iterson  2 , Luke J Laffin  3
Affiliations
Review

Contemporary Strategies to Manage High Blood Pressure in Patients with Coexistent Resistant Hypertension and Heart Failure With Reduced Ejection Fraction

Katherine Lang et al. Cardiol Ther. 2021 Jun.

Abstract

Resistant hypertension (RH) represents an advanced subtype of hypertension that is complex to diagnose and treat. Compared with general hypertension, RH increases the risk patients will develop more advanced cardiovascular complications, including heart failure with reduced ejection fraction (HFrEF). As expected, the prevalence of RH has increased since the introduction of lower blood pressure targets included in the recent 2017 American blood pressure guidelines. The array of pharmacotherapies available to treat both hypertension and HFrEF has also expanded within the past decade. However, the efficacy of these cutting-edge pharmacotherapies has not come without a more advanced understanding of the important adjunct role non-pharmacological therapies play in helping with the management of both hypertension and HFrEF. In this review, we provide a summary of the latest pharmacological and non-pharmacological strategies that can be used to initiate treatment and optimize long-term blood pressure control in patients with coexistent RH and HFrEF.

Keywords: Heart failure; Heart failure with reduced ejection fraction; Hypertension; Resistant hypertension.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Schematic outlining a therapeutic algorithm for a patient with coexistent resistant hypertension and heart failure with reduced ejection fraction. Listed treatment strategies and therapies have not been directly tested and safety and efficacy confirmed using a randomized controlled clinical trial study design in patients with coexistent resistant hypertension or heart failure with reduced ejection fraction. Implementation of any component of this proposed therapeutic algorithm should be individualized and preceded by a careful assessment of the patient, taking into consideration current clinical status, medical history, and relevant guideline statements and peer-reviewed evidence in resistant hypertension or heart failure with reduced ejection fraction
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • Approaches in Managing Resistant Hypertension: A Review.
    Mittal S, Jain P, Sharma R, Ponde CK, Routray S, Chopra S, Kumar R, Naqvi S, Mittal R. Mittal S, et al. Cureus. 2024 Apr 8;16(4):e57804. doi: 10.7759/cureus.57804. eCollection 2024 Apr. Cureus. 2024. PMID: 38721164 Free PMC article. Review.

References

    1. Lawes CM, Vander Hoorn S, Rodgers A, International Society of H Global burden of blood-pressure-related disease, 2001. Lancet. 2008;371:1513–1518. - PubMed
    1. Collaboration NCDRF Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 191 million participants. Lancet. 2017;389:37–55. - PMC - PubMed
    1. Sprint Research Group. Wright JT, Jr, Williamson JD, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373:2103–2116. - PMC - PubMed
    1. Whelton PK, Carey RM, Aronow WS, et al. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: a Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017;71:e127–248. - PubMed
    1. Virani SS, Alonso A, Benjamin EJ, et al. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation. 2020;141:e139–e596. - PubMed