High blood pressure

High pressure in your blood vessels is called hypertension. Hypertension that is not controlled increases your risk of developing heart failure (HF) in two ways:

  1. It causes narrowing, constriction and increased resistance in your blood vessels, including those that supply your heart, leading to reduced flow to the heart muscle which may weaken or injure your heart.
  2. It adds to your heart’s workload. When the pressure is too high, your heart must pump harder than normal to keep the blood circulating. To cope with increased pressure, your heart muscle thickens and becomes larger to compensate. However, this extra work may eventually lead to the heart being unable to pump as hard as needed (decompensation) and lead to symptomatic heart failure.

If you are diagnosed with heart failure, it is important to keep monitoring your blood pressure. Normal blood pressure varies with age, but high blood pressure (BP above 140/80 mmHg) will worsen your heart function, increase your symptoms and will require long-term treatment. For more information on monitoring your own blood pressure refer to section Taking your blood pressure and pulse.

Hypertension that is not well controlled increases your risk of heart failure. When the pressure is too high, your heart has to pump harder than normal to keep the blood circulating. The narrowing and blocking of blood vessels caused by high blood pressure increases your risk of developing heart failure. Narrowed arteries are less elastic and make it more difficult for the blood to circulate around the body.

Treatment includes lifestyle modifications as well as medications. Both are used in treating your heart failure. Lifestyle modifications include dietary sodium restriction (salt), regular physical activity, smoking cessation, etc.

Medications used to treat heart failure usually lower blood pressure and these drugs are recommended first. If blood pressure is still uncontrolled, there are numerous additional drugs that can be used. Note that not all medicines that are used to treat high blood pressure are good for heart failure patients. You should discuss your questions about medicines with your doctor or nurse.

Drug classes that can be used to treat your high blood pressure include:
– Angiotensin converting enzyme inhibitors (ACE-inhibitors)
– Angiotensin receptor blockers (ARB)
– Angiotensin receptor blocker/Neprilysin inhibitor (ARNI)
– Beta-blockers
– Calcium channel blockers
– Mineralocorticoid receptor antagonists (aldosterone antagonists)
– Diuretics (thiazides)

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ESC Guidelines for Heart Failure

What patients need to know

This guide for patients from the European Society of Cardiology aims to provide an overview of the latest evidence-based recommendations for the diagnosis and treatment of heart failure.

In particular, it should help patients to understand the:

  • main types of heart failure
  • medicines used to treat heart failure
  • devices that may be appropriate
  • importance of rehabilitation
  • management by a multidisciplinary team
  • importance of self-care in managing your own condition

Learn more


A series of 9 simple, captivating animations explaining heart failure and its treatment.

These narrated animations explain how a healthy heart works, what happens to it in heart failure and how various treatments work to improve your health.


In this section you can watch, listen or read interviews with other people with heart failure and their caregivers.


and share your own views and experiences with other patients, families and caregivers.

heartfailurematters.org is a European Society of Cardiology website

The heartfailurematters.org website was developed under the direction of the Heart Failure Association of the European Society of Cardiology (ESC). The ESC is a world leader in the discovery and dissemination of best practices in cardiovascular medicine. Our members and decision-makers are healthcare professionals who volunteer their time and expertise to represent professionals in the field of cardiology in Europe and beyond.

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