Chandra A, Vaduganathan M, Lewis EF, et al. - Since data characterizing health-related quality of life (HRQL) in patients with heart failure with preserved ejection fraction (HFpEF) employing validated metrics are limited, researchers report baseline HRQL in the largest HFpEF trial to date–the PARAGON-HF (Prospective Comparison of ARNI with ARB Global Outcomes in HFpEF) trial. Either sacubitril/valsartan or valsartan was randomly given to symptomatic patients with HFpEF (≥ 45%) (≥ 50 years of age) in the PARAGON-HF trial. Baseline Kansas City Cardiomyopathy Questionnaire (KCCQ) at randomization was completed by 4,735 of 4,822 patients in the PARAGON-HF trial. The mean KCCQ-Overall Summary score was estimated to be 71. In almost all domains, lower KCCQ scores were reported by patients in the PARAGON-HF trial vs the PARADIGM-HF (Prospective Comparison of ARNI with an ACE-Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial. In both the PARAGON-HF and PARADIGM-HF trials, New York Heart Association functional class, female gender, lower extremity edema, body mass index, angina, dyspnea, and paroxysmal nocturnal dyspnea were identified as the strongest independent clinical correlates of adverse HRQL. Findings revealed that HRQL was largely worse in women. After accounting for the difference in demographics, functional status, and symptom burden, HRQL was found similar in HFpEF and heart failure with reduced ejection fraction.