Personally, I have no experience of heart failure but, after having read a lot about it in the posts of other people, here is what it looks like from the technical standpoint.
If BP starts being very high and there is no reaction to different tested medications, it is not rare case that people get the diagnoses of HF, with the ejection fraction being very low (the lowest data I can remember is 15%, not meaning that it can't be still lower).
In several posts, there was said that, after some time, ejection fraction has improved from itself, reaching say 40%. It has often been explained as the consequence of having used some medications, but the truth may be quite different.
In the attempt to control the BP, which is critically high, "the pump" is at first regulated via BPM, which is lowered, lowering that way the blood output flowrate, and lowering the BP at the same time. It is known that people with extremely high BP often get bradycardic, with the HR in the low 40-ties. If such one regulation gives no result and the BP remains still very high, the control system of the heart has no other option, but to switch from RPM regulation to additional volume regulation. It means, the heart does not squize fully in each cycle, but uses only (adjustable) part of its disposable ventricle volumes, reducing this way output flowrate further, and this way reducing the BP further. When the cause of the increased BP goes away, the control system will increase ejection fraction from itself.
The idea is that, despite "heart failure" sounds very odd and could be understood as the irreversible process of deteriorating heart condition, it may be just temporary reduction for the needs of heart output flowrate regulation, with good chances to revert to the old normal value. Just as an idea...
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High BP doesn't cause HF. Unregulated high BP over time can/will damage your heart muscle. This damage will affect the way your heart functions and it's ability to supply your organs with the essential oxygenated blood they need to be able to function themselves. No amount of medication will repair the heart, once damaged the damage is permanent. The medications given to manage HF do just that, they manage the condition and help improve the functionality but they do not cure it. Yes, your ejection fraction (EF) can improve to near normal levels however that is due to the medication, if you stop the medication then the functionality will deteriorate again and then continue to worsen.
Additionally HF is a syndrome that is caused by various conditions not just high blood pressure, a heart attack can damage the heart enough to cause HF, as do viruses, genetic conditions, etc.
Whilst I understand that the terminology can be a bit daunting for someone who has mild HF, the terminology is correct as the heart is failing to work as it should, no different to kidney failure etc. Plus for many who have severe HF the terminology is correct as basically the heart is failing significantly.
In addition to reduced EF HF (known as HFrEF, which is where the heart isn't able to eject enough blood from the heart to supply the the body's needs) there another type of HF known as preserved EF HF (HFpEF) which is when the heart isn't able to fill up properly.
Thank you so much for finding the time to write a comment! I have looked at your profile and read some of your posts. Maybe you are not aware of it, but there is a lot of very, very interesting information there! I intend to read carefully about your husband's case - there is a lot of to learn! I will feel free to contact you afterwords, if there is something I do not understand... We are all here to learn - actually researching the problem we have.
You're very welcome to ask any questions, I may not know the answer though 🤣 my husband has had HF for some years following a heart attack & cardiac arrest, because he has congnitive issues caused by a cardiac arrest I mainly deal with his health. So, I research, ask questions and then research again so that I can fight his corner, so to speak. That doesn't mean I'm always right about something, if someone tells me I've got it wrong & why, I'll go off and find out if what I'm being told is correct as ultimately the more I know, the more I can help my husband.
Obviously any posts/comments about my husband are only a snapshot of his health, experiences etc & so may not be applicable for others.
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