The prevalence of hypertension is steadily increasing, even with the expanded use of antihypertensive medications.16 It is widely recognized that hypertension is associated with increased cardiovascular and all-cause mortality independently of other risk factors.14,17 Specific HF mortality attributable to hypertension is probably underreported because of the competing adjudication for stroke or myocardial infarction (MI) at the end of the spectrum of hypertensive cardiovascular death. Biykem Bozkurt, MD, PhD, FAHA, Chair David Aguilar, MD, FAHA Anita Deswal, MD, MPH, FAHA Sandra B. Dunbar, RN, PhD, FAHA Gary S. Francis, MD, FAHA Tamara Horwich, MD, MS, FAHA Mariell Jessup, MD, FAHA Mikhail Kosiborod, MD, FAHA Allison M. Pritchett, MD Kumudha Ramasubbu, MD Clive Rosendorff, MD, PhD, DScMed, FAHA Clyde Yancy, MD, MSc, FAHA On behalf of the American Heart Association Heart Failure and Transplan- tation Committee of the Council on Clinical Cardiology; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular and Stroke Nursing; Council on Hypertension; and Council on Quality and Outcomes Research 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 2016 American Heart Association, Inc. Key Words: AHA Scientific Statements cardiovascular diseases comorbidity diabetes mellitus heart failure hyperlipidemia hypertension obesity risk factors AHA Scientific Statement Bozkurt et al Hypertension Plays a Significant Role in the Development of HF Elevated levels of diastolic BP and especially systolic BP (SBP) are major risk factors for the development of One of the most impactful observations from the Framingham cohort was that the cumulative incidence of HF was significantly higher in patients with hyperten- (Figure 1) Among 5143 patients, 91% of the patients with HF had hypertension antedating the devel- opment of HF, underlining that in the majority of patients with HF, hypertension was a contributing cause. 