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Getting the latest healthcare news for you
Getting the latest healthcare news for you
Heart failure with preserved ejection fraction (HFpEF) now has more treatment options than ever. The American College of Cardiology released an updated expert consensus decision pathway recommending SGLT2 inhibitors and nonsteroidal mineralocorticoid receptor antagonists (MRAs) as the backbone of therapy, with GLP-1-based drugs added for patients with obesity. The document also cautions against routine beta-blocker use in HFpEF — a notable shift from standard heart failure thinking.
The American College of Cardiology (ACC) has released an updated Expert Consensus Decision Pathway (ECDP) for HFpEF, reflecting a rapidly evolving treatment landscape since the 2023 version. The document, published in the Journal of the American College of Cardiology, now recommends that all eligible HFpEF patients receive both an SGLT2 inhibitor and a nonsteroidal MRA (preferably finerenone, based on the FINEARTS-HF trial) as the foundation of optimal medical therapy. GLP-1 receptor agonists and dual GIP/GLP-1 agonists are endorsed for patients with obesity, supported by the STEP-HFpEF and SUMMIT trials.
The pathway also reinforces the importance of accurate diagnosis — ruling out HFpEF mimics like cardiac amyloidosis, valvular disease, and renal causes — and frames HFpEF within the broader context of cardiovascular-kidney-metabolic (CKM) syndrome, calling for multidisciplinary care.
Key Takeaways:
Why it matters: HFpEF accounts for more than half of all heart failure cases, and until recently had few proven therapies. This updated roadmap gives clinicians actionable, evidence-based guidance on a growing arsenal of treatments — bridging the gap while formal guideline updates catch up.
