Hypertension and heart failure: focus on high-risk populations

PURPOSE OF REVIEW: Hypertension is a common, modifiable precursor to heart failure. Lifetime risk for development varies across age, sex, race and ability to achieve adequate blood pressure control. RECENT FINDINGS: Although meta-analyses seemingly support intensive blood pressure control to reduce incident heart failure, randomized clinical trials are limited and do not enroll a large number of female, minority, elderly or treatment-resistant patients. Heterogeneity further adds to complexity; however, enhanced cognizance of these disparities can aid clinicians in creating patient-centered care plans. SUMMARY: High-risk populations constitute an overwhelming percentage of the comorbid disease burden. Future clinical trials must reflect this diverse population to truly determine appropriate blood pressure targets and pharmacotherapy to reduce cardiovascular events.