The ACC/AHA guidelines give three class I recommendations to medically treat chronic diastolic congestive heart failure.

The first is to control the heart rate in patients with atrial fibrillation in order to improve diastolic filling. Tachycardia shortened diastolic filling time and so keeping heart rates < 100 beats per minute and preferably between 60-80 beats per minute will improve cardiac output when significant diastolic heart failure is present. Rate control can be achieved using beta-blockers, non-dihydropyridine calcium channel blockers, or digoxin.

The second is to control systolic and diastolic blood pressure and the third is to use diuretics to control pulmonary congestion and peripheral edema.