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May 1, 2026Journal of the Practice of Cardiovascular SciencesOpen Access

Indian Expert Consensus on Heart Failure with Preserved Ejection Fraction: A Phenotype-based Approach to Diagnosis and Management

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Why the study?

Indian patients with HFpEF present younger with distinct comorbidity burdens compared to Western populations, creating challenges for existing management strategies and necessitating India-specific guidance.

Population

25 HF experts from India and Europe

Design

Modified Delphi consensus process

Key result

Finerenone reduced the incidence of the primary composite endpoint of kidney failure, sustained eGFR decline ≥40%, or renal death by 18% (HR 0.82) compared to placebo in patients with chronic kidney disease and type 2 diabetes.

Authors

SSSandeep SethVCVijay ChopraNSNakul Sinha

Discussion

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Overview

Supports phenotype-based HFpEF care in India; extends global recommendations with region-specific guidance.

Study Design

Type

RCT (n=5,674)

Blinding

Double-blind

Randomization

Randomized

Multicenter

Yes

Structured PICO

P
Population
5,674 adult patients with chronic kidney disease associated with type 2 diabetes, followed for a median of 2.6 years.
I
Intervention
Phenotype-based approach to diagnosis and management, including SGLT2 inhibitors, MRAs (finerenone), and GLP-1 RAs

Main Result

Hazard Ratio: 0.82 (95% CI 0.73–0.93)

Absolute Event Rate: 17.8% vs 21.1%

p-value: p=0.001

This expert consensus provides India-specific, phenotype-based recommendations for the diagnosis and management of HFpEF, emphasizing SGLT2 inhibitors, MRAs, and GLP-1 RAs.

Cite This Study

Seth et al. (2026) conducted an RCT in Chronic kidney disease associated with type 2 diabetes (n=5,674). Finerenone vs. Placebo was evaluated on Composite of kidney failure, sustained eGFR decline ≥40% or renal death (HR 0.82, 95% CI 0.73-0.93, p=0.001). Finerenone reduced the incidence of the primary composite endpoint of kidney failure, sustained eGFR decline ≥40%, or renal death by 18% (HR 0.82) compared to placebo in patients with chronic kidney disease and type 2 diabetes.

synapsesocial.com/papers/6a93fce2235a0bf22c92d1a0https://doi.org/10.4103/jpcs.jpcs_64_26
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