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. In a trial of patients with HFpEF and MI, patients ran- domized to propranolol had at 32-month follow-up a 35% reduction in mortality rate.S9.2.2-3 After 21 months of treatment in patients with HFrEF and HFpEF, compared with placebo, those randomized to nebivolol had a 14% reduction in mortality or CVD hospitalization if they had HFrEF and a 19% reduction if they had HFpEF.S9.2.2-4 In patients with HFpEF, the primary outcome (a composite of CVD death or HF hospitalization) was observed in 22% for candesartan and 24% for placebo (11% reduc- tion), but fewer patients receiving candesartan were hos- pitalized for HF.S9.2.2-5 The use of nitrates in the setting of HFpEF is associated with a signal of harm and in most situations should be avoided. For many other common antihypertensive agents, including alpha blockers, beta blockers, and calcium channel blockers, limited data ex- ist to guide the choice of antihypertensive therapy in the setting of HFpEF.S9.2.2-21 Renin-angiotensin-aldosterone system inhibition, however, with ACE inhibitor or ARB and especially MRA would represent the preferred choice. A shared decision-making discussion, with the patient influenced by clinician judgment, should drive the ultimate choice of antihypertensive agents. 9.3. Chronic Kidney Disease Recommendations for Treatment of Hypertension in Patients With CKD References that support recommendations are summarized in Online Data Supplements 37 and 38 and Systematic Review Report. COR LOE Recommendations I SBP: B-RSR 1. Adults with hypertension and CKD should be treated to a BP goal of less than DBP: C-EO IIa B-R 2. 