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Heart Failure With Preserved Ejection Fraction (HFpEF)

Cardiovascular
8
Pipeline Programs
12
Companies
14
Clinical Trials
4 recruiting
1
Approved Products

Pipeline by Development Stage

Preclinical
Phase 1
Phase 1/2
Phase 2
Phase 2/3
Phase 3
On Market
0
3
0
1
0
3
1
Early DiscoveryClinical DevelopmentMarket

Drug Modality Breakdown

Small Molecule
2100%
+ 15 programs with unclassified modality

Cardiovascular is a $69.4B mature market dominated by anticoagulants and metabolic therapies with stable blockbuster portfolios.

$69.4B marketMature→ Stable30 products15 companies

Key Trends

  • FXa inhibitors (ELIQUIS, XARELTO) command 62% of market spending, creating limited room for new entrants
  • SGLT2 inhibitors gaining traction in heart failure indication, signaling expansion beyond traditional anticoagulation
  • Multiple patent cliffs (JANUVIA 2027, OPSUMIT 2029) create near-term revenue vulnerability but reinvestment pressure

Career Verdict

Strong choice for commercial, clinical operations, and device integration roles; limited opportunity for innovative pipeline development given market maturity.

AI-generated market analysis based on FDA, CMS, ClinicalTrials.gov, and hiring data

Market Leaders

#1ELIQUISStable
$18.3B
#2JARDIANCEGrowing
$8.8B
#3XARELTOStable
$6.3B
#4FARXIGAGrowing
$4.3B
AstraZeneca·Peak15.4yr
#5JANUVIADeclining
$4.1B
Merck & Co.·LOE_Approaching1.1yr

Drug Class Breakdown

FXa Inhibitors (Apixaban/Rivaroxaban)
$42.8B(62%)

Mature, stable revenue base

SGLT2 Inhibitors
$13.1B(19%)

Growing in heart failure and renal indications

DPP4 Inhibitors
$4.1B(6%)

Declining as LOE approaches 2027

ARBs and Combination Therapies
$3.4B(5%)

Stable in heart failure management

Endothelin Receptor Antagonists and Prostacyclin Agonists
$1.8B(3%)

Niche pulmonary hypertension market

Career Outlook

Stable

Cardiovascular careers are stable but not expanding; the market is mature, dominated by blockbuster franchises with predictable commercial cycles and patent cliffs. Professionals entering this space should expect strong compensation (Commercial $210K avg, Medical Affairs $201K avg) but limited opportunity to drive breakthrough innovation. Device company roles offer better growth trajectories than pharma, particularly in remote monitoring, diagnostics, and patient engagement technologies.

Breaking In

Target device companies (Abbott, Medtronic) for growth potential; if joining pharma, focus on Commercial or Clinical Operations roles where hiring is active and compensation is competitive.

For Experienced Professionals

Leverage cardiovascular expertise to move into medical device strategy, digital health partnerships, or adjacent therapeutic areas; R&D opportunity is limited and may require lateral moves to access innovation-focused roles.

In-Demand Skills

Healthcare economics and payer management (anticoagulation safety monitoring, cost-effectiveness)Real-world evidence generation (postmarket surveillance for FXa inhibitors)Digital health and remote patient monitoring integrationClinical trial execution in large, established patient populationsRegulatory expertise in label expansions (SGLT2 inhibitor indications)

Best For

Commercial/Sales roles (mature market execution)Medical Science Liaisons (managing healthcare provider relationships on established therapies)Clinical Operations/Project Managers (managing large Phase 3/4 programs)Regulatory Affairs (label expansion strategy, patent cliff preparation)Health Economics and Outcomes Research (demonstrating value in competitive anticoagulation market)

Hiring Landscape

$130K-$210K

Cardiovascular hiring is concentrated in device companies (Abbott 337, Medtronic 317) rather than pharma, reflecting the therapeutic area's reliance on hardware solutions and patient management infrastructure. Pharma hiring (Johnson & Johnson 261, Bristol Myers Squibb 52) is heavily weighted toward Commercial (468 roles) and Clinical Operations (296 roles), with minimal R&D investment (14 roles). Medical device integration and remote patient monitoring expertise are increasingly valued as the market consolidates.

1,386
Open Roles
5
Companies Hiring
5
Departments

Top Hiring Companies

337Growing
317Growing

By Department

Commercial(34%)
$210K
Clinical Operations(21%)
$180K
Engineering(13%)
$145K
Medical Affairs(1%)
$201K
Research & Development(1%)
$194K

Device companies offer more growth opportunities; pharma roles are high-paying but oriented toward mature market execution rather than innovation.

On Market (1)

Approved therapies currently available

AstraZeneca
FARXIGAApproved
dapagliflozin
AstraZeneca
oral2014
4.3B Part D

Competitive Landscape

12 companies ranked by most advanced pipeline stage

AstraZeneca
AstraZenecaCAMBRIDGE, United Kingdom
5 programs
2
1
1
1
DapagliflozinPhase 3Small Molecule1 trial
VerinuradPhase 21 trial
AZD4831Phase 11 trial
AZD9977Phase 11 trial
Determination of the Prevalence of Unrecognized Heart Failure Among Patients at Risk in Urban Areas N/A
Active Trials
NCT04232345Completed32Est. Mar 2021
NCT03843060Completed14Est. Apr 2019
NCT04327024Completed159Est. Apr 2022
+1 more trials
Sandoz
SandozAustria - Kundl
2 programs
2
LCZ696Phase 31 trial
sacubitril/valsartanPhase 3Small Molecule1 trial
Active Trials
NCT03909295Terminated52Est. Nov 2019
NCT03988634Completed467Est. Dec 2022
Secretome Therapeutics
1 program
1
STM01Phase 11 trial
Active Trials
NCT06560762Recruiting12Est. Dec 2025
Verona Pharma
Verona PharmaUK - London
1 program
Aerobic eccentric interventionN/A1 trial
Active Trials
NCT06826963Recruiting15Est. Sep 2025
Occlutech
OcclutechSwitzerland - Schaffhausen
1 program
Atrial Flow RegulatorN/A2 trials
Active Trials
NCT07532369Not Yet Recruiting25Est. Sep 2026
NCT05136820Active Not Recruiting15Est. Feb 2029
BaroPace
BaroPaceWA - Issaquah
1 program
BaroPacingN/A1 trial
Active Trials
NCT06036186Completed16Est. Apr 2024
Berlin Heart
Berlin HeartTX - The Woodlands
1 program
Determination of the Prevalence of Unrecognized Heart Failure Among Patients at Risk in Urban Areas N/A
Philips
PhilipsNetherlands - Amsterdam
1 program
Determination of the Prevalence of Unrecognized Heart Failure Among Patients at Risk in Urban Areas N/A1 trial
Active Trials
NCT07185100Recruiting600Est. Dec 2036
Abbott
AbbottABBOTT PARK, IL
1 program
ILR implantationN/A1 trial
Active Trials
NCT01989299Completed113Est. Jun 2020
Rhythm Pharmaceuticals
1 program
Personalized cardiac pacingN/A
Medtronic
MedtronicNJ - Phillipsburg
1 program
Personalized cardiac pacingN/A1 trial
Active Trials
NCT06678841Recruiting700Est. Feb 2029
Parexel
ParexelMA - Boston
1 program
AZD4831PHASE_1

Trial Timeline

Clinical trial activity over time

2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
Sandozsacubitril/valsartan
SandozLCZ696
AstraZenecaDapagliflozin
AstraZenecaVerinurad
Secretome TherapeuticsSTM01
AstraZenecaAZD4831
AstraZenecaAZD9977
OcclutechAtrial Flow Regulator
PhilipsDetermination of the Prevalence of Unrecognized Heart Failure Among Patients at Risk in Urban Areas
MedtronicPersonalized cardiac pacing
Verona PharmaAerobic eccentric intervention
BaroPaceBaroPacing
OcclutechAtrial Flow Regulator
AbbottILR implantation

Clinical Trials (14)

Total enrollment: 2,724 patients across 14 trials

NCT03988634Sandozsacubitril/valsartan

Changes in NT-proBNP, Safety, and Tolerability in HFpEF Patients With a WHF Event (HFpEF Decompensation) Who Have Been Stabilized and Initiated at the Time of or Within 30 Days Post-decompensation (PARAGLIDE-HF)

Start: Jun 2019Est. completion: Dec 2022467 patients
Phase 3Completed

An Open-label Extension Study Evaluating Safety and Tolerability of LCZ696 in Subjects Who Completed PARAGON-HF in Japan.

Start: May 2019Est. completion: Nov 201952 patients
Phase 3Terminated

DETERMINE-preserved - Dapagliflozin Effect on Exercise Capacity Using a 6-minute Walk Test in Patients With Heart Failure With Preserved Ejection Fraction

Start: Apr 2019Est. completion: Jul 2020504 patients
Phase 3Completed

Study of Verinurad in Heart Failure With Preserved Ejection Fraction

Start: May 2020Est. completion: Apr 2022159 patients
Phase 2Completed

Study in Participants With Heart Failure With Preserved Ejection Fraction (HFpEF)

Start: Mar 2025Est. completion: Dec 202512 patients
Phase 1Recruiting

A Study to Assess the Effect AZD4831 in Japanese and Chinese Healthy Volunteers

Start: Jan 2020Est. completion: Mar 202132 patients
Phase 1Completed

A Phase 1 Study to Assess the Pharmacokinetics of AZD9977 Administered Alone and in Combination With Itraconazole in Healthy Volunteers

Start: Feb 2019Est. completion: Apr 201914 patients
Phase 1Completed
NCT07532369OcclutechAtrial Flow Regulator

Occlutech AFR Fontan Study

Start: May 2026Est. completion: Sep 202625 patients
N/ANot Yet Recruiting
NCT07185100PhilipsDetermination of the Prevalence of Unrecognized Heart Failure Among Patients at Risk in Urban Areas

Determination of the Prevalence of Unrecognized Heart Failure Among Patients at Risk in Urban Areas Across Germany Using CMR

Start: Sep 2025Est. completion: Dec 2036600 patients
N/ARecruiting
NCT06678841MedtronicPersonalized cardiac pacing

ELEVATE-HFpEF Clinical Study

Start: Jul 2025Est. completion: Feb 2029700 patients
N/ARecruiting
NCT06826963Verona PharmaAerobic eccentric intervention

Feasibility and Effectiveness of Eccentric Exercise in Sarcopenic Older Adults with Heart Failure: a Pilot Study

Start: Oct 2024Est. completion: Sep 202515 patients
N/ARecruiting

Study for the Treatment of Heart Failure With Preserved Ejection Fraction Associated With High Blood Pressure Using Right Atrial Pacing Controlled by the PressurePaceTM System

Start: Aug 2023Est. completion: Apr 202416 patients
N/ACompleted
NCT05136820OcclutechAtrial Flow Regulator

Flow Regulation by Opening the SepTum in Patients With Heart Failure; a Prospective, Randomized, Sham-controlled, Double-blind, Global Multicenter Study

Start: Mar 2023Est. completion: Feb 202915 patients
N/AActive Not Recruiting
NCT01989299AbbottILR implantation

Ventricular Tachyarrhythmia Detection by Implantable Loop Recording in Patients With Heart Failure and Preserved Ejection Fraction

Start: Nov 2014Est. completion: Jun 2020113 patients
N/ACompleted

Related Jobs in Cardiovascular

Phase Legend

PreclinicalLab & animal studies
Phase 1Safety & dosing
Phase 2Efficacy testing
Phase 3Large-scale trials
On MarketApproved & available

Key Insights

3 late-stage (Phase 3) programs, potential near-term approvals
4 actively recruiting trials targeting 2,724 patients
12 companies competing in this space

The information on this page is for informational purposes only and should not be used as a substitute for professional medical advice. Drug information is sourced from FDA, DailyMed, and other government databases. Adverse event data from FAERS does not establish causation. Always consult a healthcare professional for medical decisions.