Management of Comorbidities in Chronic Heart Failure CLINICAL STATEMENTS AND GUIDELINES remodeling, and improve LV function.57,58 Although these beneficial effects of ACE inhibitors, ARBs, and -blockers are not specific for patients with hypertension or for treatment of BP, a significant proportion of patients in these trials (40% 60%) had a history of hypertension, and the beneficial effects could be generalized to the hypertensive population. Treatment of Hypertension in Patients With Established HF How Aggressively to Treat BP in Patients With HF? There have not been compelling data to justify a single BP target in treating hypertension in patients with es- tablished HF. Former guidelines and position papers differ significantly in such threshold definitions and lack strong evidence for treatment targets of hypertension in Therefore, the optimal BP target for the treat- ment of hypertension in patients with HF is not firmly established. The 2007 AHA scientific statement on the treatment of hypertension in the prevention and manage- ment of ischemic heart disease recommended a target BP of <130/80 mmHg in patients with HF.48 Similarly, the 2002 AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke 9 identified the BP treatment goal as <130/85 mmHg if HF was present. However, these recommendations were empirical, not supported by trial evidence.9,48 Furthermore, there is con- cern about potential adverse outcomes with BP lowering that is too aggressive, which was further supported by the change to a higher BP threshold of 140/90 mmHg in patients <60 years of age and <150/90 mmHg in patients 60 years of age in the 2014 evidence-based guideline for the management of high BP in adults.7 It should be noted, however, that the writing committee did not address BP treatment targets in patients with es- tablished HF. 