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Pharmacologic Management of Heart Failure with Preserved Ejection Fraction (HFpEF) in Older Adults.
Drugs Aging
January 2025
Program for the Care and Study of the Aging Heart, Department of Medicine, Weill Cornell Medicine, 420 East 70th St, New York, NY, LH-36510063, USA.
There are several pharmacologic agents that have been touted as guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). However, it is important to recognize that older adults with HFpEF also contend with an increased risk for adverse effects from medications due to age-related changes in pharmacokinetics and pharmacodynamics of medications, as well as the concurrence of geriatric conditions such as polypharmacy and frailty. With this review, we discuss the underlying evidence for the benefits of various treatments in HFpEF and incorporate key considerations for older adults, a subpopulation that may be at higher risk for adverse drug events.
View Article and Find Full Text PDFLong-term hemodynamic responses and reverse remodeling after pharmacotherapy in HFpEF versus HFrEF: a systematic review and meta-analysis.
Am J Physiol Heart Circ Physiol
January 2025
Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, The Netherlands.
The acute response to therapeutic afterload reduction differs between heart failure with preserved (HFpEF) versus reduced ejection fraction (HFrEF), with larger left ventricular (LV) stroke work augmentation in HFrEF compared to HFpEF. This may (partially) explain the neutral effect of HFrEF-medication in HFpEF. It is unclear whether such differences in hemodynamic response persist and/or differentially trigger reverse remodeling in case of long-term afterload reduction.
View Article and Find Full Text PDFGender inequalities in prescribing and initiation patterns of guideline-recommended drugs after acute myocardial infarction.
BMC Public Health
January 2025
Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
Background: European guidelines recommend the prescription of certain drugs after acute myocardial infarction (AMI). The existence of gender differences in pharmacological treatment after an AMI has been described. This study aims to describe and analyse, using real-world data (RWD), whether there are gender differences in the prescribing patterns and initiation of treatment in secondary prevention after a first AMI, and which are the factors that explain these differences.
View Article and Find Full Text PDFSafety of Beta Blockers for the Treatment of PHACE Syndrome: A Systematic Review.
J Am Acad Dermatol
January 2025
Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Dermatology, The Hospital for Sick Children, Toronto, ON, Canada.
The impact of specialist cardiology inpatient care on the long-term outcomes of non-ST-segment elevation myocardial infarction (NSTEMI): A nationwide cohort study.
Int J Cardiol
January 2025
Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, UK; National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK. Electronic address:
Background: Specialist cardiac care has been shown to reduce inpatient mortality following non-ST segment myocardial infarction (NSTEMI), but whether this benefit extends beyond index admission is unclear.
Methods: Using the linked Myocardial Ischaemia National Audit Project (MINAP) registry, and Office for National Statistics mortality recording, we included 425,205 NSTEMI patients admitted to UK hospitals, between January 2005 and March 2019 that survived to discharge. 217,964 (52 %) were admitted to a specialty cardiac ward.
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