Holistic approach to drug therapy in a patient with heart failure

Area of Science:

• Cardiology
• Pharmacology
• Public Health

Background:

• Heart failure (HF) affects over 26 million globally, representing a significant public health challenge.
• HF treatment has rapidly advanced, with current guidelines emphasizing four foundational pharmacotherapies for reduced ejection fraction (HFrEF).

Approach:

• This review synthesizes current evidence on optimizing pharmacotherapy for HFrEF.
• It examines key considerations for individualized and patient-centered drug management.
• The approach includes shared decision-making, therapy initiation and sequencing, and addressing polypharmacy and adherence.

Key Points:

• The four pillars of HFrEF pharmacotherapy include angiotensin receptor neprilysin inhibitors (ARNIs) or ACE inhibitors, beta blockers, mineralocorticoid receptor antagonists, and SGLT2 inhibitors.
• Individualized care requires tailoring treatment based on patient-specific factors beyond guideline recommendations.
• Addressing challenges like polypharmacy and ensuring patient adherence are crucial for effective HF management.

Conclusions:

• Optimizing pharmacotherapy in HFrEF necessitates a holistic, individualized approach.
• Shared decision-making and careful consideration of drug interactions and adherence are paramount.
• This strategy ensures patient-centered care within the evolving landscape of HF treatment.