Table 3.

Summary of the benefit of HF medication with BP-lowering property in HF patients (secondary prevention)

Disease status	Intervention (BP target or drugs)	Findings	Reference number
HFpEF	PARAGON HF: sacubitril valsartan versus valsartan in HFpEF patients	Sacubitril valsartan did not significantly affect primary event rate ratio	[62]
	CHARM- preserved trial: candesartan versus placebo in HFpEF patients. candesartan SBP 136.3 (baseline) to 129 (during trial)	Lesser patients experienced HF hospitalization in candesartan group versus placebo group (adjusted hazard ratio: 0.84, p = 0.047)	[51]
	I-PRESERVE: irbesartan versus placebo in ≥60 years HFpEF patients	Irbesartan did not significantly affect primary event ratio versus placebo	[63]
HFrEF	Val-HeFT: valsartan versus placebo in HFrEF patients	RR reduction of new AF by 37% in valsartan arm	[61]
HFrEF	SOLVD: enalapril versus placebo in HFrEF patients	Fewer patients died or were hospitalized for worsening HF in enalapril versus placebo group (risk reduction 26%)	[52]
	ELITE II study: losartan (ARB) versus captopril (ACEi) in HFrEF patients	Fewer patients died in losartan versus captopril group (estimated annual mortality rate: 11.7% [losartan] vs. 10.4% [captopril])	[53]
	PARADIGM-HF: angiotensin-neprilysin inhibition (LCZ696) versus enalapril in HFrEF patients SBP baseline 122 ± 15 versus 121 ± 15	Fewer patients had cardiovascular death or hospitalization in LCZ696 group versus enalapril (RR reduction: 20%)	[64]

BP, blood pressure; AF, atrial fibrillation; ACEi, angiotensin-converting enzyme inhibitors; ARB, angiotensin receptor blockers; CHARM-Preserved, Candesartan in Heart Failure assessment of reduction in mortality and morbidity and preserved left ventricular ejection fraction; CI, confidence interval; ELITE II, the losartan heart failure survival study; HF, heart failure; HFpEF, HF with preserved ejection fraction; HFrEF, HF with reduced ejection fraction; I-PRESERVE, irbesartan in heart failure with preserved systolic function trial; PARADIGM HF, prospective comparison of arni[angiotensin receptor–neprilysin inhibitor] with acei, to determine impact on global mortality and morbidity in heart failure; PARAGON HF, The prospective comparison of ARNI, with ARB, global outcomes in HF, with preserved ejection fraction; RR, relative risk; SBP, systolic blood pressure; SOLVD, studies of left ventricular dysfunction; SPRINT, systolic blood pressure intervention trial; Val-HeFT, valsartan heart failure trial.