Refer to the Management of Hypertension in Patients With ACS section above. 6.5. Therapeutic Strategies The therapeutic goals in patients presenting with HF are to reverse hemodynamic abnormalities, to relieve symptoms, and to initiate treatments that will decrease disease progres- sion and improve survival. 6.6. Nonpharmacological Therapies Sodium restriction is important in the management of both hypertension and LV dysfunction. Exercise training238,239 has been shown to reduce recurrent cardiac events in patients with LV dysfunction resulting from ischemic causes. In the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) study, exercise training was associated with modest reductions in both all-cause mortal- ity or hospitalization and cardiovascular mortality or HF hos- pitalization after adjustment for highly prognostic baseline Exercise training also conferred significant improvements in self-reported health status compared with For patients with HF, close medical supervision and careful monitoring of the BP response to exercise and of the ECG for ventricular arrhythmias are appropriate.242,243 Other nonpharmacological therapies, as discussed in the Risk Factor Reduction section, are also appropriate. These include management of dyslipidemia, diabetes mellitus, and obesity, as well as smoking cessation. 6.7. Pharmacological Therapies When an antihypertensive regimen is devised, optimal con- trol of BP should remain the primary goal, with the choice of drugs determined by the concomitant medical problems (eg, CAD, diabetes mellitus, or renal disease). Ultimately, an appropriate antihypertensive regimen frequently consists of several drugs used in combination. 