Which of the following therapies would enhance blood pressure control in a patient with HFpEF?

Utilizing spironolactone is particularly effective for enhancing blood pressure control in patients with heart failure with preserved ejection fraction (HFpEF). Spironolactone, a mineralocorticoid receptor antagonist, works by promoting sodium and water excretion while sparing potassium. This diuretic effect can help alleviate fluid overload, a common issue in heart failure patients, potentially leading to improved blood pressure management.

Moreover, spironolactone has been shown in clinical studies to improve outcomes in heart failure patients by reducing hospitalization rates and mortality, particularly in those with symptomatic heart failure. While it directly affects blood pressure, its additional benefits on heart failure symptoms and outcomes make it a valuable therapy in managing patients with HFpEF.

On the other hand, increasing the dose of amlodipine, initiating carvedilol, or administering metoprolol may have roles in hypertension or heart failure in general, but they do not specifically target the syndrome or management nuances of HFpEF. Amlodipine primarily acts as a calcium channel blocker and while it can help with blood pressure, it does not have the same definitive effects on heart failure management as spironolactone. Carvedilol and metoprolol