What is the clinical evidence from this study?

Study design: Editorial. Population: Heart failure with preserved ejection fraction (HFpEF). Intervention: Systolic blood pressure target < 130 mmHg. Primary outcome: All-cause mortality (HR 0.74, 95% CI 0.53-1.04).

February 28, 2026Open Access

JSH 2025 in global perspective: blood pressure management in HFpEF across major guidelines

Q: What are the key findings of this study?

Achieving a systolic blood pressure < 130 mmHg in patients with heart failure with preserved ejection fraction demonstrated a trend toward reduced all-cause mortality (HR 0.74) and reduced heart failure hospitalization by 20%.

Key Result

Achieving a systolic blood pressure < 130 mmHg in patients with heart failure with preserved ejection fraction demonstrated a trend toward reduced all-cause mortality (HR 0.74) and reduced heart failure hospitalization by 20%.

Structured PICO

Population

Patients with heart failure (HFrEF and HFpEF) across stages A-D with elevated blood pressure

Intervention

Blood pressure management according to JSH2025 guidelines (target SBP <130 mmHg for HFpEF, individualized for HFrEF)

Comparator

Other major hypertension guidelines (ESC2024, ESH2023, AHA2025)

JSH2025 provides updated blood pressure management recommendations for heart failure, notably strongly recommending SBP <130 mmHg for HFpEF based on a new meta-analysis.

Main Result

Effect estimate: HR 0.74 (95% CI 0.53-1.04)

Limitations

The meta-analysis did not include RCTs with SBP < 130 mmHg management as a pure intervention.
Moderate to strong heterogeneity in several outcomes (I2 ranging from 50% to 86%).
Many included studies used an EF ≥ 45% definition, potentially including HFmrEF patients.
The evidence level was graded as low.

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Cite This Study

Matsumoto et al. (Tue,) conducted a editorial in Heart failure with preserved ejection fraction (HFpEF). Systolic blood pressure target < 130 mmHg was evaluated on All-cause mortality (HR 0.74, 95% CI 0.53-1.04). Achieving a systolic blood pressure < 130 mmHg in patients with heart failure with preserved ejection fraction demonstrated a trend toward reduced all-cause mortality (HR 0.74) and reduced heart failure hospitalization by 20%.

synapsesocial.com/papers/6a025a449cddff7633412ac2 https://doi.org/https://doi.org/10.1038/s41440-026-02580-1