It is a highly debatable topic if the variances between systolic and diastolic are related to left ventricular traits and negative results, as well as mean arterial pressure (MAP) in patients with heart failure (HF) with preserved ejection fraction. We examined these relationships in 3428 TOPCAT trial patients with HFpEF (51.5% women; mean age, 68.6 years). We registered affiliation sizes and risks proportions with one standard deviation rise in MAP and heartbeat pressure. The septal and posterior wall thickness were 0.016 cm and 0.014 cm respectively for MAP’s association sizes (P≤0.039) in multivariable-adjusted tests. Plus, the E/A ratio is -0.15, E/e′ is -0.66, and ejection fraction is -0.64%. All of them were not dependent on pulse pressure. With change also applied for MAP, E/A ratio and longitudinal strain rose with greater heartbeat pressure with association sizes adding up to 0.067 (P=0.026) and 0.40% (P=0.023). In multivariable-changed investigations of placebo and spironolactone groupings, decreased MAP and increased heartbeat pressure foretold the main composite end point (P≤0.028) and hospitalized HF (P≤0.002). On the other hand, MAP was also highly related to total mortality (P≤0.007). Sensitivity tests covered by gender, median age, and region spawned confirmatory outcomes with exemption for the association of negative results with heartbeat pressure in patients with age ≥69 years. Taking everything into account, the clinical utilization of MAP and heartbeat pressure might refine hazard gauges in patients with heart failure (HF) with preserved ejection fraction (HFpEF). The verdicts may assist in further examination for the advancement of HFpEF preventative systems focusing on pulsatility and circulatory strain control.