The evidence-based management of patients with heart failure and a preserved ejection fraction (HFPEF), among whom older obese women constitute the predominant population, has been largely unsatisfactory. The outcomes of randomized trials of pharmacologic therapeutic strategies for HFPEF have been disappointing.1 Consequently, therapies for patients with HFPEF are directed primarily toward controlling hypertension (which is considered etiologic) and toward reducing symptoms, such as exertional dyspnea and exercise intolerance. An effective management strategy for patients with HFPEF beyond blood pressure control was highlighted as an evidence gap in the 2013 Heart Failure guideline.2
Wenger NK. Lifestyle Interventions to Improve Exercise Tolerance in Obese Older Patients With Heart Failure and Preserved Ejection Fraction. JAMA. 2016;315(1):31–33. doi:10.1001/jama.2015.17347
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