Physicians' Academy for Cardiovascular Education

High prevalence of polypharmacy in older patients hospitalized for HF

Polypharmacy in Older Adults Hospitalized for Heart Failure

Literature - Unlu O, Levitan EB, Reshetnyak E, et al. - Circ Heart Fail 2020, e006977,

Introduction and methods

Polypharmacy is associated with many adverse outcomes, such as falls, disability and hospitalizations [1,2]. And this is in particular relevant for older adults with HF as they are vulnerable to the adverse effects of polypharmacy caused by age-related changes in pharmacokinetics and pharmacodynamics [3], alterations in CV structure and function [4] and conditions as frailly and cognitive impairment [5,6].

Although it is known that polypharmacy can result in harm, there is limited data on real-world information on polypharmacy in the setting of HF. During or shortly after hospitalization medication errors and adverse drug events are common [7], therefore information on medication pattern during this time period is important.

This study examined polypharmacy during HF hospitalization using a cohort of older patients hospitalized for HF derived from the REGARDS study (Reasons for Geographic and Racial Differences in Stoke).

REGARDS was a national prospective observational cohort of community-dwelling black and white men and women ≥45 years from the US recruited from 2003-2007. Baseline data collection was done at telephone interview and 1 month later blood and urine samples were collected, as well as physiological measures. During follow-up, participants were every 6 months asked to report hospitalization for a CV condition, including HF. This analysis included those ≥65 years who were hospitalized for HF (n=558). Data from REGARDS, medical charts, the American Hospital Associations annual survey database and Medicare’s Hospital Compare website were used. Number of standing medications at admission and discharge was examined. Polypharmacy was defined as taking at least 10 medications.

Main results


In this subset of participants from REGARDS which were older patients hospitalized for HF, prevalence of polypharmacy (at least 10 medications) was high. Prevalence of polypharmacy increased over time. And finally, the majority of medications prescribed to older patients with HF were nonCV medications. The authors conclude: ‘These findings support the need to develop strategies to mitigate the negative effects of polypharmacy among older adults with HF, potentially starting with formalized processes that can improve prescribing practices for nonCV medications’.


Show references

Find this article online at Circ Heart Fail.

Share this page with your colleagues and friends: