Evidence-Based Prescribing and Polypharmacy for Patients With Heart Failure
Authors: Ankeet S. Bhatt, Niteesh K. Choudhry
Journal: Annals of Internal Medicine (2021)

Ideas and OpinionsAugust 2021Evidence-Based Prescribing and Polypharmacy for Patients With Heart FailureAnkeet S. Bhatt, MD, MBA and Niteesh K. Choudhry, MD, PhDAnkeet S. Bhatt, MD, MBABrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (A.S.B., N.K.C.). and Niteesh K. Choudhry, MD, PhDBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (A.S.B., N.K.C.).Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-1427 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The last decades have seen tremendous advances in drug therapies for chronic health conditions, including heart failure with reduced ejection fraction (HFrEF). Randomized clinical trials have established the efficacy of many medications, which have reduced mortality rates and averted hospitalizations for patients with heart failure. In parallel, scientific advancements have improved the ability to treat atherosclerotic cardiovascular disease, diabetes, and chronic kidney disease, among other common comorbid conditions.Scientific progress has also had unintended consequences. To receive guideline-concordant care, persons with HFrEF must take many medications every day: a renin–angiotensin and neprilysin antagonist, a β-adrenergic blocker, a mineralocorticoid receptor antagonist, ...References:1. Unlu O, Levitan EB, Reshetnyak E, et al. Polypharmacy in older adults hospitalized for heart failure. Circ Heart Fail. 2020;13:e006977. [PMID: 33045844] doi:10.1161/CIRCHEARTFAILURE.120.006977 CrossrefMedlineGoogle Scholar2. Goyal P, Bryan J, Kneifati-Hayek J, et al. Association between functional impairment and medication burden in adults with heart failure. J Am Geriatr Soc. 2019;67:284-291. [PMID: 30488944] doi:10.1111/jgs.15654 CrossrefMedlineGoogle Scholar3. Lauffenburger JC, Isaac T, Trippa L, et al. 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[PMID: 33176459] doi:10.1161/CIRCHEARTFAILURE.120.007094 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (A.S.B., N.K.C.).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-1427.Corresponding Author: Niteesh K. Choudhry, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120; e-mail, [email protected]harvard.edu.Current Author Addresses: Dr. Bhatt: Shapiro Cardiovascular Center, 70 Francis Street, Boston, MA 02115.Dr. Choudhry: Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120.Author Contributions: Administrative, technical, or logistic support: A.S. Bhatt, N.K. Choudhry.Collection and assembly of data: N.K. Choudhry.Conception and design: A.S. Bhatt, N.K. Choudhry.Critical revision for important intellectual content: A.S. Bhatt, N.K. Choudhry.Drafting of the article: A.S. Bhatt, N.K. Choudhry.Final approval of the article: A.S. Bhatt, N.K. Choudhry.This article was published at Annals.org on 29 June 2021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics August 2021Volume 174, Issue 8Page: 1165-1166KeywordsAtherosclerotic cardiovascular diseaseDecision makingDrug interactionsDrug therapyHeart failureHospital medicineMineralocorticoidsPatientsReceptor antagonist therapy ePublished: 29 June 2021 Issue Published: August 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...