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

Authors

• Hadi Skouri
• Nicolas Girerd
• Luca Monzo
• Mark C Petrie
• Michael Böhm
• Marianna Adamo
• Wilfried Mullens
• Gianluigi Savarese
• Mehmet Birhan Yilmaz
• Offer Amir
• Antoni Bayes-Genis
• Biykem Bozkurt
• Javed Butler
• Ovidiu Chioncel
• Alexandre Mebazaa
• Jose L Merino
• Brenda Moura
• Piotr Ponikowski
• Petar Seferovic
• Giuseppe M C Rosano
• Marco Metra

Language

English

Publication Date

4-1-2025

Journal

European Journal of Heart Failure

DOI

10.1002/ejhf.3618

PMID

40012353

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.

Keywords

Humans, Blood Pressure, Disease Management, Heart Failure, Hypotension, Societies, Medical, Stroke Volume

Published Open-Access

yes

Recommended Citation

Skouri, Hadi; Girerd, Nicolas; Monzo, Luca; et al., "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" (2025). Faculty, Staff and Students Publications. 6642.
https://digitalcommons.library.tmc.edu/baylor_docs/6642