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. 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. 