What medication is used to raise blood pressure in heart failure patients?

• A. Lisinopril
• B. Digoxin
• C. Norepinephrine
• D. Furosemide

Answer: (C)

When a heart failure patient is hypotensive, the goal is to restore perfusion pressure to vital organs. Norepinephrine raises blood pressure by activating alpha-1 receptors, causing vasoconstriction that increases systemic vascular resistance and mean arterial pressure. It also has beta-1 effects that can modestly boost cardiac contractility, improving cardiac output and organ perfusion. This combination makes it the best choice for raising BP in this context, especially in cardiogenic shock or low-flow states. Lisinopril lowers blood pressure by reducing afterload and RAAS activity, which would worsen hypotension and isn’t used to acutely support BP. Digoxin improves contractility but doesn’t reliably raise blood pressure and is more for symptom relief and rate control. Furosemide reduces preload with diuresis and can lower BP further, not for increasing BP.