Clinical and Research Considerations for Patients With Hypertensive Acute Heart Failure: A Consensus Statement from the Society of Academic Emergency Medicine and the Heart Failure Society of America Acute Heart Failure Working Group

Sean P. Collins, Phillip D. Levy, Jennifer L. Martindale, Mark E. Dunlap, Alan B. Storrow, Peter S. Pang, Nancy M. Albert, G. Michael Felker, Gregory J. Fermann, Gregg C. Fonarow, Michael M. Givertz, Judd E. Hollander, David J. Lanfear, Daniel J. Lenihan, Jo Ann M. Lindenfeld, W. Frank Peacock, Douglas B. Sawyer, John R. Teerlink, Javed Butler

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1 Scopus citations

Abstract

Management approaches for patients in the emergency department (ED) who present with acute heart failure (AHF) have largely focused on intravenous diuretics. Yet, the primary pathophysiologic derangement underlying AHF in many patients is not solely volume overload. Patients with hypertensive AHF (H-AHF) represent a clinical phenotype with distinct pathophysiologic mechanisms that result in elevated ventricular filling pressures. To optimize treatment response and minimize adverse events in this subgroup, we propose that clinical management be tailored to a conceptual model of disease based on these mechanisms. This consensus statement reviews the relevant pathophysiology, clinical characteristics, approach to therapy, and considerations for clinical trials in ED patients with H-AHF.

Original languageEnglish
Pages (from-to)618-627
Number of pages10
JournalJournal of cardiac failure
Volume22
Issue number8
DOIs
StatePublished - Aug 1 2016
Externally publishedYes

Keywords

  • Emergency
  • Heart failure
  • Hypertension

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    Collins, S. P., Levy, P. D., Martindale, J. L., Dunlap, M. E., Storrow, A. B., Pang, P. S., Albert, N. M., Felker, G. M., Fermann, G. J., Fonarow, G. C., Givertz, M. M., Hollander, J. E., Lanfear, D. J., Lenihan, D. J., Lindenfeld, J. A. M., Peacock, W. F., Sawyer, D. B., Teerlink, J. R., & Butler, J. (2016). Clinical and Research Considerations for Patients With Hypertensive Acute Heart Failure: A Consensus Statement from the Society of Academic Emergency Medicine and the Heart Failure Society of America Acute Heart Failure Working Group. Journal of cardiac failure, 22(8), 618-627. https://doi.org/10.1016/j.cardfail.2016.04.015