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. 2023 Aug 2;12(15):5090. doi: 10.3390/jcm12155090

Table 2.

Therapeutic targets and medications in the management of hypertensive heart failure.

Congestion Blood Pressure Lowering and
Cardioprotection

  • Loop diuretics

(furosemide, torasemide, 
bumetanide)

  • ACEi/ARB/Sacubitril-valsartan

  • Steroidal MRAs (spironolactone, eplerenone)

  • B-blockers

Blood Pressure Targets

Systolic BP
110–130 mmHg

Time in therapeutic range > 75 % 		Comments:
1. Additional use of thiazide diuretics or carbonic anhydrase inhibitors in cases with diuretic resistance
2. Thiazide diuretics may be considered in decongested patients instead of loop diuretics for blood pressure control. 		Comments:
1. Besides effectively lowering BP, all the aforementioned classes of antihypertensives are cardioprotective.
2. Vasodilating beta-blockers with a favorable metabolic profile (e.g, carvedilol, nebivolol) may be preferable.
3. Beta-blockers are first-line agents in eccentric hypertrophy.
4. B-blockers should be used in selected patients with concentric hypertrophy (e.g., atrial fibrillation, angina, resistant hypertension).
5. The additional use of dihydropyridine calcium channel blockers should be considered when BP cannot be otherwise controlled.

BP, blood pressure; ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; MRA, mineralocorticoid receptor antagonist.