Adults with HFpEF and persistent hypertension after management of volume overload should be prescribed ACE inhibitors or ARBs and beta blockers titrated to attain SBP of less than 130 Synopsis Approximately 50% of patients with HF have The ejection fraction in these studies has varied from >40% to 55%.S9.2.2-2 Patients with HFpEF are usually older women with a history of hypertension. Obesity, CHD, DM, AF, and hyperlipidemia are also highly preva- lent in patients with HFpEF.S9.2.2-2,S9.2.2-11,S9.2.2-12 Hypertension is the most important cause of HFpEF, with a prevalence of 60% to 89% in large RCTs, epidemiological studies, and HF Patients with HFpEF also have an exag- gerated hypertensive response to exercise.S9.2.2-14 Hypertensive acute pulmonary edema is an expression of HFpEF.S9.2.2-15 BP control is important for prevention of HFpEF in patients with hypertension.S9.2.2-2,S9.2.2-16 S9.2.2-19 ALLHAT showed that treatment of hypertension with chlorthalidone reduced the risk of HF compared with amlodipine, doxazosin, and Improved BP control also reduces hospi- talization, CVD events, and mortality.S9.2.2-2,S9.2.2-16 S9.2.2-19 Recommendation-Specific Supportive Text 1. Diuretics are the only drugs used for the treatment of hypertension and HF that can adequately control the fluid retention of HF. Appropriate use of diuretics is also crucial to the success of other drugs used for the treatment of hypertension in the presence of HF. The use of inappropriately low doses of diuretics can result in fluid retention. Conversely, the use of inap- propriately high doses of diuretics can lead to volume contraction, which can increase the risk of hypotension and renal insufficiency. Diuretics should be prescribed to all patients with hypertension and HFpEF who have evidence of, and to most patients with a prior history of, fluid retention. 2. 