Clinical Management and Therapeutic Optimization of Patients with Heart Failure with Reduced Ejection Fraction and Low Blood Pressure. A Clinical Consensus Statement of the Heart Failure Association (HFA) of the ESC

Despite major advancements in heart failure (HF) management and guideline recommendations over the past two decades, real-world evidence highlights suboptimal implementation of guideline-directed medical therapy (GDMT) for HF with reduced ejection fraction (HFrEF). Low blood pressure (BP) is common in HFrEF patients and represents a major perceived barrier to implementing life-saving treatments in clinical practice, as physicians are often concerned about symptomatic hypotension and its consequences. Although low BP can be seen in those hospitalized with signs of shock, the most common scenario involves non-severe, asymptomatic hypotension in patients receiving foundational therapy for HFrEF, where premature down-titration or discontinuation of GDMT should be avoided. This clinical consensus statement provides a comprehensive overview of low BP in HFrEF, including its definition, risk factors, and effects of HF therapies on BP. We propose management pathways to optimize HFrEF treatment in the context of low BP, ultimately aiming to improve patient outcomes.

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Publication Details

Journal
European Journal of Heart Failure
Published
2025-02-26
DOI
https://doi.org/10.1002/ejhf.3618
Citations
28
Primary Topic
Heart Failure Treatment and Management
Type
article
Field-Weighted Citation Impact
38.87

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article

Clinical Management and Therapeutic Optimization of Patients with Heart Failure with Reduced Ejection Fraction and Low Blood Pressure. A Clinical Consensus Statement of the Heart Failure Association (HFA) of the ESC

Giuseppe Rosano, Nicolas Girerd, Michael Böhm, Mark C. Petrie et al.
28 citations
European Journal of Heart Failure
Heart Failure Treatment and Management
38.87
article

Clinical Management and Therapeutic Optimization of Patients with Heart Failure with Reduced Ejection Fraction and Low Blood Pressure. A Clinical Consensus Statement of the Heart Failure Association (HFA) of the ESC

Giuseppe Rosano, Nicolas Girerd, Michael Böhm, Mark C. Petrie, Gianluigi Savarese, Antoni Bayés‐Genís, Piotr Ponikowski, Biykem Bozkurt, Javed Butler, Luca Monzo, Ovidiu Chioncel, Marianna Adamo, Brenda Moura, Petar Seferović, Alexandre Mebazaa, José Luís Merino, Hadi Skouri, Wilfried Müllens, Mehmet Birhan Yılmaz, Offer Amir, Marco Metra
article en
28 citations

Abstract

Despite major advancements in heart failure (HF) management and guideline recommendations over the past two decades, real-world evidence highlights suboptimal implementation of guideline-directed medical therapy (GDMT) for HF with reduced ejection fraction (HFrEF). Low blood pressure (BP) is common in HFrEF patients and represents a major perceived barrier to implementing life-saving treatments in clinical practice, as physicians are often concerned about symptomatic hypotension and its consequences. Although low BP can be seen in those hospitalized with signs of shock, the most common scenario involves non-severe, asymptomatic hypotension in patients receiving foundational therapy for HFrEF, where premature down-titration or discontinuation of GDMT should be avoided. This clinical consensus statement provides a comprehensive overview of low BP in HFrEF, including its definition, risk factors, and effects of HF therapies on BP. We propose management pathways to optimize HFrEF treatment in the context of low BP, ultimately aiming to improve patient outcomes.

European Journal of Heart FailureVol. 27(4)
Serbian Academy of Sciences and Arts (RS), Vita-Salute San Raffaele University (IT), Inserm (FR), Carol Davila University of Medicine and Pharmacy (RO), St George's, University of London (GB), University of Balamand (LB), Baylor College of Medicine (US), Università degli studi di Cassino e del Lazio Meridionale (IT), Dokuz Eylül University (TR), Université Paris Cité (FR), Hadassah Medical Center (IL), Hospital Universitario La Paz (ES), Karolinska Institutet (SE), San Raffaele University of Rome (IT), British Heart Foundation (GB), University of Mississippi (US), Wroclaw Medical University (PL), University of Belgrade (RS), Sheikh Shakhbout Medical City (AE), Universitätsklinikum des Saarlandes (DE), Centro de Investigación en Red en Enfermedades Cardiovasculares (ES), Assistance Publique – Hôpitaux de Paris (FR), Surgical Specialties (Canada) (CA), Hospital La Paz Institute for Health Research (ES), Baylor Medical Center at Garland (US), CUF Porto Hospital (PT), Armed Forces Hospital (SA), Hôpital Lariboisière (FR), IRCCS Ospedale San Raffaele (IT), University of Arts in Belgrade (RS), Ziekenhuis Oost-Limburg (BE), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Hospital Universitari Germans Trias i Pujol (ES), French Clinical Research Infrastructure Network (FR), Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT), University of Glasgow (GB), University of Brescia (IT), Hasselt University (BE), Université de Lorraine (FR), Saarland University (DE)
Eli Lilly and Company, AstraZeneca, Edwards Lifesciences, Cytokinetics, Vifor Pharma, Servier, Respicardia
Openalex Percentile: Top 0%
Heart Failure Treatment and Management
38.87
DOIOpen Access PDFOpenAlex
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