This is supported by the observation that SBP has usually been lowered to a normal range of 110 to 130 mmHg in most successful HF treatment trials with After optimization of HF treatment, if BP is not controlled, further treatment strategies target- ing both BP and HF can be used. It should also be noted that the BP-lowering effects of HF medications may re- late to the baseline BP; that is, there may be a greater BP-lowering effect in patients with a higher baseline BP. However, the beneficial effects of the HF medications are usually independent of the baseline BP or changes in BP and do not vary according to baseline BP or reduc- tions in SBP levels.60 62 Medication Choices for the Treatment of Hypertension in Patients With HF Currently, there are no randomized, large-scale trials comparing the effectiveness of different antihyperten- sive medications targeting optimal treatment of BP solely in patients with hypertension and established HF. Thus, most evidence comes from hypertension clinical trials that have not excluded patients with a history of HF. In patients with established HF, drugs that have been shown to improve outcomes for patients with HF gen- erally also lower BP. Thus, the emphasis should be on initiating and optimizing guideline-directed medical treat- ment of HF, which will likely help control BP at target doses. Therefore, patients with hypertension and HF with reduced EF (HFrEF) are treated with diuretics, ACE in- hibitors (or ARBs if ACE inhibitor intolerant), -blockers, and aldosterone antagonists unless contraindicated8 (Table 4). Although thiazide or thiazide-like diuretics are usually recommended for the treatment of hypertension,7 in pa- tients with current or prior symptoms of HF who have evi- dence of fluid retention, loop diuretics are usually used8 (Table 4). 