Heart failure with preserved ejection fraction (HFpEF) is a systemic condition characterized by complex pathophysiological mechanisms, affecting over 50% of all heart failure patients, with a five-year mortality rate ranging from 50% to 75%. HFpEF is highly heterogeneous, with diverse etiologies, pathophysiological mechanisms, and clinical manifestations, all of which complicate its management and treatment. Despite these present challenges, significant progresses have been made in the management of HFpEF in recent years. Certain medications have been shown to improve quality of life and reduce the risk of adverse events in HFpEF patients. This article provides a review of the latest clinical evidence on pharmacological treatments for HFpEF, focusing on the disease's unique pathophysiological mechanisms, thereby offering a solid theoretical foundation and practical guidance for its management.

射血分数保留的心力衰竭（HFpEF）是一种病理生理机制复杂的系统性疾病，占所有心力衰竭类型50%以上，5年死亡率高达50%~75%，危害极大。HFpEF具有极强的异质性，病因、病理生理机制及临床表现多样，治疗困难。尽管如此，近年来HFpEF治疗仍取得了很大的进步，部分药物已被证实可改善HFpEF患者生活质量，减少不良事件的发生。本文基于HFpEF独特的病理生理机制，对HFpEF相关药物治疗的最新临床证据进行综述，旨在为HFpEF的综合治疗提供理论基础和实践指导。