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

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...

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Bibliographic Details
Published in:Academic emergency medicine 2016-08, Vol.23 (8), p.922-931
Main Authors: Collins, Sean P., Levy, Phillip D., Martindale, Jennifer L., Dunlap, Mark E., Storrow, Alan B., Pang, Peter S., Albert, Nancy M., Felker, G. Michael, Fermann, Gregory J., Fonarow, Gregg C., Givertz, Michael M., Hollander, Judd E., Lanfear, David E., Lenihan, Daniel J., Lindenfeld, JoAnn M., Peacock, W. Frank, Sawyer, Douglas B., Teerlink, John R., Butler, Javed, Hiestand, Brian C.
Format: Article
Language:English
Subjects:
Acute Disease
Advisory Committees
Aged
Biomedical Research
Clinical trials
Consensus
Diuretics
Dose-Response Relationship, Drug
Emergency medical care
Emergency Medicine - organization & administration
Emergency Service, Hospital - organization & administration
Female
Genotype & phenotype
Heart failure
Heart Failure - drug therapy
Heart Failure - etiology
Humans
Hypertension - complications
Hypertension - drug therapy
Male
Medical treatment
Societies, Medical
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Summary: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 that is 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.
ISSN:1069-6563
1553-2712
DOI:10.1111/acem.13025