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Older patients with heart failure are particularly vulnerable due to a wide range of associated comorbidities, disability, and frailty. This population often receives multiple prescriptions, increasing the risk of adverse drug reactions, non-adherence, and drug interactions. Deprescribing, which involves reducing the number of medications to the lowest clinically reasonable limit, has the potential to decrease the risk of drug interactions and enhance patients' quality of life. Moreover, simplifying medication regimens may improve adherence to essential heart failure therapies. This scientific review aims to comprehensively examine deprescribing strategies in older patients with heart failure. It explores the rationale, challenges, benefits, and potential approaches to optimizing medication regimens in this vulnerable population. Furthermore, the review suggests a practical, step-by-step approach for performing deprescribing in older patients with heart failure.
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http://dx.doi.org/10.1007/s11739-024-03791-5 | DOI Listing |
ESC Heart Fail
September 2025
Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.
Heart failure (HF) is a multifactorial and pathophysiological complex syndrome, involving not only neurohormonal activation but also oxidative stress, chronic low-grade inflammation, and metabolic derangements. Central to the cellular defence against oxidative damage is nuclear factor erythroid 2-related factor 2 (Nrf2), a transcription factor that orchestrates antioxidant and cytoprotective responses. Preclinical in vitro and in vivo studies reveal that Nrf2 signalling is consistently impaired in HF, contributing to the progression of myocardial dysfunction.
View Article and Find Full Text PDFZhong Nan Da Xue Xue Bao Yi Xue Ban
May 2025
Department of Cardiovascular Medicine, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Sympathectomy, as an emerging treatment method for cardiovascular diseases, has received extensive attention in recent years. Stereotactic radiotherapy (SRT), a precise and noninvasive therapeutic technique, has gradually been introduced into interventions targeting the sympathetic nervous system and has shown promising prospects in the management of cardiovascular conditions. Using three-dimensional imaging, SRT can accurately localize sympathetic ganglia and deliver high-energy radiation to disrupt nerve fibers, thereby achieving effects similar to conventional sympathectomy while reducing surgery-related complications and shortening recovery time.
View Article and Find Full Text PDFEur J Heart Fail
September 2025
Evidence-based Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan.
Eur J Heart Fail
September 2025
Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Eur J Heart Fail
September 2025
Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Aims: The estimated glucose disposal rate (eGDR) is a simple, non-invasive measure of insulin resistance. In this exploratory analysis of FINEARTS-HF, we evaluated whether lower eGDR, reflecting greater insulin resistance, is associated with adverse outcomes in heart failure (HF).
Methods And Results: The eGDR was calculated at baseline using waist circumference, glycated haemoglobin, and hypertension status.