Unanswered Questions Regarding Blood Pressure Management for HF Prevention

  • Sergio H. R. Ramalho
  • Amil M. ShahEmail author
Hypertension and the Heart (Bharathi Upadhya, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hypertension and the Heart


Purpose of Review

Evaluate the relevant new findings regarding hypertension treatment and heart failure prevention published in the past 3 years.

Recent Findings

In a recent secondary analysis of Systolic Blood Pressure Intervention Trial (SPRINT), randomization of more than 9000 patients > 50 years old with high cardiovascular risk but without diabetes to intensive treatment targeting blood pressure < 120/80 mmHg compared to standard treatment targeting < 140/90 mmHg significantly reduced incident heart failure. While such benefits outweighed potential harm, adverse events including renal dysfunction, hypotension, and syncope occurred more frequently with intensive treatment. Following SPRINT, existing guidelines differ in their recommendations and controversies still exist. Key persistent questions include the role of intensive treatment in younger adults and those at lower cardiovascular risk and optimal approaches to translate clinical trial findings into clinical practice in a sustainable fashion.


Aggressively treating hypertension to targets below 120/80 mmHg prevents heart failure in high-risk patients. However, evidence is lacking to younger patients and those at lower cardiovascular risk.


Systolic heart failure Diastolic heart failure Prevention Systolic blood pressure Diastolic blood pressure Treatment Prevention 


Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Cardiovascular MedicineBrigham and Women’s HospitalBostonUSA
  2. 2.Health Sciences and Technologies ProgramUniversity of BrasiliaBrasiliaBrazil

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