HFpEF and CAD Management Algorithm 1. Consider revascularization based on current guidelines for CAD and HFpEF* 2. Statins: all patients unless contraindicated 3. Aspirin: all patients unless contraindicated 4. Clopidogrel (or equivalent antiplatelet): if indicated by current guidelines (eg, recent PCl or ACS) 5. ACE inhibitor: consider in all patients unless contraindicated 6. ARB: if ACE inhibitor contraindicated 7. ß-BIocker: perform exercise testing to evaluate for Cl. If Cl, first consider pacemaker then start vasodilating ß-blocker. If no CI, treat with vasodilating ß-blocker.* 8. Angina: consider ranolazine if angina is not controlled by above medications. Also consider nitrates, calcium channel blockers. * 9. Optimal BP management: if BP is not controlled by ACE inhibitor/ARB + vasodilating ß-blocker, optimize fluid status (hypervolemia may exacerbate hypertension in patients with increased arterial stiffness), add chlorthalidone, consider spironolactone 10. Lifestyle modification: diet, exercise, cardiac rehabilitation, smoking cessation, weight loss (consider bariatric surgery in morbid obesity); treat obstructive sleep apnea 11. Enroll in HFpEF clinical trial #HFpEF #CAD #Management #Algorithm #cardiology
