Hypertension and heart failure: Navigating blood pressure targets and medication titration and tolerance

This article briefly reviews the latest hypertension guidelines and how they should be individualised in patients with heart failure (HF), including the two specific phenotypes: HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). Key recent trials and guidelines show that HF medications remain beneficial and safe to use even in patients without overt hypertension, provided that they are tolerated. We also outline practical strategies for titration and selection of HF medications, most of which affect BP, in an outpatient setting. These strategies are applicable to both normotensive patients and those with pre-existing hypertension.