• DOI:10.1161/CIR.0000000000000450
• Corpus ID: 8321004

Contributory Risk and Management of Comorbidities of Hypertension, Obesity, Diabetes Mellitus, Hyperlipidemia, and Metabolic Syndrome in Chronic Heart Failure: A Scientific Statement From the American Heart Association.

@article{Bozkurt2016ContributoryRA,
  title={Contributory Risk and Management of Comorbidities of Hypertension, Obesity, Diabetes Mellitus, Hyperlipidemia, and Metabolic Syndrome in Chronic Heart Failure: A Scientific Statement From the American Heart Association.},
  author={Biykem Bozkurt and David Aguilar and Anita Deswal and Sandra B. Dunbar and Gary S. Francis and Tamara B Horwich and Mariell Jessup and Mikhail N. Kosiborod and Allison M. Pritchett and Kumudha Ramasubbu and Clive Rosendorff and Clyde W. Yancy},
  journal={Circulation},
  year={2016},
  volume={134 23},
  pages={
          e535-e578
        }
}

• B. Bozkurt, D. Aguilar, +9 authors C. Yancy
• Published 6 December 2016
• Medicine
• Circulation

The comorbidities of hypertension, diabetes mellitus, obesity, hyperlipidemia, and metabolic syndrome are common in patients with heart failure (HF) and affect clinical outcomes.1–3 Interestingly, although these comorbidities are associated with the development of incident HF in the general population, in patients with established HF, their contributory roles to clinical outcomes are not predictable, and their management is quite challenging. Recent American College of Cardiology Foundation (ACCF)/American Heart Association (AHA) guidelines have addressed the role of lifestyle modification,4 treatment of blood cholesterol,5 and management of overweight and obesity6 in the general population and in patients with increased cardiovascular risk, and a recent report from the Eighth Joint National Committee addressed the management of hypertension.7 However, these guidelines did not specifically address the management of such comorbidities in patients with HF. Similarly, the most recent ACCF/AHA HF practice guidelines8 in 2013 addressed the overall management of comorbidities in patients with HF in broad terms, but again, specific and detailed recommendations on how to manage hypertension, obesity, diabetes mellitus, hyperlipidemia, and metabolic syndrome are lacking. The intent of this AHA scientific statement is to summarize data relevant to contributory risk and to provide guidance on the management of hypertension, obesity, diabetes mellitus, hyperlipidemia, and metabolic syndrome in the development and prognosis of HF to provide recommendations (Table 1) and to foster communication between physicians and other healthcare professionals and patients on the management of these comorbidities. Recommendations in this document are based on published studies and the multidisciplinary expertise of the writing group and harmonized with published practice guidelines from the ACC/AHA4–6,8–12 and other organizations.7,13–15

View this table:

Table 1.
Applying Classification of Recommendations and Level of Evidence

Hypertension is a worldwide epidemic; in many countries, 50% of …