Heart failure & cardiomyopathies

Effects of pharmacological blood pressure lowering in heart failure with mildly reduced or preserved ejection fraction: a meta-analysis

HeartPublished systematic review and meta-analysis of randomised clinical trials

Pooled result · Composite of cardiovascular death and HF hospitalisationResult — go to the resultRelative risk 0.86 95% CI 0.83–0.89

Authors' conclusion

In patients with HFmrEF/HFpEF, there was no significant association between pharmacological BP lowering and clinical outcomes, suggesting that BP lowering alone is unlikely to explain all the benefits observed with the use of recently established HF therapies.

Study context

Population
Patients with heart failure (HF) with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF)
Participants
39,452 patients18 studies
Comparison
Any blood pressure (BP) lowering treatment to placebo, usual care or another drug class
Outcome
Composite of:
  • Cardiovascular death
  • HF hospitalisation
Methodological detailsrandom effects meta-analysis and meta-regression with inverse variance weighting
  • Random effects meta-analysis and meta-regression with inverse variance weighting

Pooled result

As reported in the abstract

Relative risk

0.86

95% CI 0.83–0.89

P ≤ 0.001

Pharmacological BP loweringvs placebo, usual care or another drug class
RR 0.86 (95% CI 0.83–0.89); P ≤ 0.001
Significant differences between drug classes
P = 0.018
Meta-regression: association between degree of BP reduction and treatment effects, coefficient slope
−0.0125, p=0.304

Further pooled results

OutcomeRR (95% CI)P value
HF hospitalisationsTreatment effects were not related to degree of BP reduction0.83 (0.79–0.86)P ≤ 0.001
HF hospitalisations — Meta-regression: treatment effects vs degree of BP reduction, coefficient slope
−0.0121, p=0.528

Original publication

Effects of pharmacological blood pressure lowering in heart failure with mildly reduced or preserved ejection fraction: a meta-analysis. Heart. Published 3 August 2026. doi:10.1136/heartjnl-2026-327872

Composed by AI from the published abstract and checked against it. How Briefs are made →

Get them every week

New studies on this topic in My Week and in your Monday e-mail.

We e-mail you a sign-in link and a code. No password, no spam.