What is the mainstay treatment for congestive heart failure with preserved ejection fraction?

Diuresis to relieve congestion stands as the mainstay treatment for congestive heart failure with preserved ejection fraction (HFpEF). In patients with HFpEF, the primary issue is often related to fluid overload and congestion, leading to symptoms such as dyspnea and edema. The use of diuretics helps to alleviate these symptoms by promoting the excretion of excess fluid through the kidneys, thereby reducing venous return to the heart (preload). This not only improves patient comfort but can also prevent hospitalization due to acute decompensation.

While other treatment options like beta-blockers and vasodilators may play roles in managing heart failure, they typically focus on improving heart function or reducing afterload, rather than directly addressing the immediate symptoms of fluid overload. Surgical interventions are rarely indicated unless there is a specific structural heart problem that requires correction. Therefore, diuretics remain the cornerstone of managing the symptomatic burdens associated with HFpEF.