The haz- ard ratios (HRs) for developing HF in hypertensives com- pared with normotensives were 2-fold higher in men and It should be noted that the risk associated with hypertension may be accentuated through its confounding effect on ischemic heart disease and other cardiovascular outcomes such as stroke. Fur- thermore, these studies predate current HF management strategies and guidelines and may no longer reflect the risk in the current population treated for hypertension. However, they underscore the importance of hyperten- sion as a cause of HF when left untreated. The residual lifetime risk for hypertension for middle-aged and elderly Table 1. Applying Classification of Recommendations and Level of Evidence A recommendation with Level of Evidence B or C does not imply that the recommendation is weak. Many important clinical questions addressed in the guidelines do not lend themselves to clinical trials. Although randomized trials are unavailable, there may be a very clear clinical consensus that a particular test or therapy is useful or effective. *Data available from clinical trials or registries about the usefulness/efficacy in different subpopulations, such as sex, age, history of diabetes, history of prior myocardial infarction, history of heart failure, and prior aspirin use. For comparative effectiveness recommendations (Class I and IIa; Level of Evidence A and B only), studies that support the use of comparator verbs should involve direct comparisons of the treatments or strategies being evaluated. Management of Comorbidities in Chronic Heart Failure CLINICAL STATEMENTS AND GUIDELINES individuals in the United States is 90%, indicating a huge public health burden20 and defining the importance of strategies to control hypertension to prevent HF. 