SynthesisHypertension research : official journal of the Japanese Society of Hypertension2025
Systolic blood pressure lower than 130 mmHg in heart failure with preserved ejection fraction: a systematic review and meta-analysis of clinical outcomes.
Synthesis in Hypertension research : official journal of the Japanese Society of Hypertension, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- JSH 2025 in global perspective: blood pressure management in HFpEF across major guidelines.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Why are SGLT2 inhibitors effective in HFpEF? Implications for interstitial fluid retention and cardio-renal interaction.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Review
- Reply to: Heart failure with preserved ejection fraction and a systolic blood pressure target of 129 mmHg: are we on cloud nine?Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- The conservative-challenging paradigm of antihypertensive therapy in JSH2025: a comparative perspective with contemporary Western guidelines.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Advancing evidence-based blood pressure targets in JSH2025.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Heart failure with preserved ejection fraction and a systolic blood pressure target of 129 mmHg: are we on cloud nine?Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Achievement rate of blood pressure control <130/80 mmHg as the core metric of implementation hypertension, based on the new JSH2025 and AHA/ACC2025 guidelines.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- JSH2025 guidelines new viewpoints.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Key highlights of the Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Association between onset age and mortality gradients in advanced cardiovascular-kidney-metabolic syndrome.Frontiers in endocrinology · 2025Observational
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6 authors.
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Abstract
The optimal blood pressure (BP) management level for patients with heart failure (HF) with preserved ejection fraction (HFpEF) remains unclear. In conjunction with the upcoming the Japanese Society of Hypertension Guidelines for the Management of Hypertension 2025 (JSH2025), we conducted a systematic review and meta-analysis to evaluate whether managing systolic BP (SBP) < 130 mmHg improves outcomes in HFpEF patients. We searched PubMed, Cochrane and Ichishi for randomized controlled trials (RCTs) published since 2012 that targeted HFpEF patients; used strict BP control, antihypertensive medications, or intensive HF management as interventions; demonstrated significant BP reduction with achieved SBP < 130 mmHg in intervention groups; and had follow-up periods ≥6 months. Six studies were included, evaluating mineralocorticoid receptor antagonists (n = 2), angiotensin receptor-neprilysin inhibitors (n = 2), intensive BP control (n = 1), and intensive HF management (n = 1). Meta-analysis showed that achieving SBP < 130 mmHg significantly reduced HF hospitalizations (relative risk [RR] [95% confidence interval (CI)] 0.80 [0.69-0.93], p = 0.005) and demonstrated a trend toward reduced all-cause mortality (RR [95% CI] 0.74 [0.53-1.04], p = 0.083). While hypotension increased (RR [95% CI] 1.35 [1.03-1.79], p = 0.03), there was no significant increase in renal dysfunction or serious adverse events. Despite limitations from indirectness (no RCTs specifically targeted SBP < 130 mmHg as primary intervention), our findings suggest that achieving SBP < 130 mmHg in HFpEF patients may improve clinical outcomes. We recommend managing HFpEF patients to achieve SBP < 130 mmHg, while carefully monitoring for hypotension.
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