Current Cardiovascular Risk Reports

, Volume 7, Issue 6, pp 495–502 | Cite as

Update on Heart Failure with Preserved Ejection Fraction

Elderly and Heart Disease (J Wei and G Azhar, Section Editors)


Heart failure with preserved ejection fraction (HFPEF) is the most common form of heart failure (HF) in older adults, and is increasing in prevalence as the population ages. Morbidity and long-term mortality in HFPEF are substantial and can be similar to HF with reduced ejection fraction (HFREF), yet HFPEF therapy remains empirical and treatment guidelines are based primarily on expert consensus. Neurohormonal blockade has revolutionized the management of HFREF, but trials in HFPEF based on this strategy have been disappointing to date. However, many recent studies have increased knowledge about HFPEF. The concept of HFPEF has evolved from a ‘cardio-centric’ model to a syndrome that may involve multiple cardiovascular and non-cardiovascular mechanisms. Emerging data highlight the importance of non-pharmacological management strategies and assessment of non-cardiovascular comorbidities. Animal models, epidemiological cohorts, and small human studies suggest that oxidative stress and inflammation contribute to HFPEF, potentially leading to development of new therapeutic targets.


Diastolic heart failure Treatment Mechanisms Hypertension 


Compliance with Ethics Guidelines

Conflict of Interest

Scott L. Hummel and Dalane W. Kitzman declare that they have no conflict of interest.

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 New York 2013

Authors and Affiliations

  1. 1.Department of Internal Medicine, Section of Cardiovascular MedicineUniversity of Michigan School of MedicineAnn ArborUSA
  2. 2.Ann Arbor Veterans Affairs Health SystemAnn ArborUSA
  3. 3.Department of Internal Medicine, Section on CardiologyWake Forest School of MedicineWinston-SalemUSA

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