Pharmacotherapy for comorbidities in chronic heart failure: a focus on hematinic deficiencies, diabetes mellitus and hyperkalemia

Expert Opin Pharmacother. 2016 Aug;17(11):1527-38. doi: 10.1080/14656566.2016.1197201. Epub 2016 Jun 13.

Abstract

Introduction: Chronic heart failure (HF) is frequently accompanied by one or more comorbidities. The presence of comorbidities in chronic HF is strongly correlated to HF severity and impaired outcome.

Areas covered: This review will address several comorbidities with high prevalence and/or high impact in patients with chronic HF, including diabetes, anemia, hematinic deficiencies, and hyperkalemia. The background and subsequent pharmacotherapeutic options of these comorbidities will be discussed. For this review, a MEDLINE search was performed.

Expert opinion: Heart failure is increasingly considered a multimorbid syndrome, including metabolic derangements and chronic inflammation. Persistent metabolic derangements and low-grade inflammation might lead to progression of HF and the development of comorbidities. Although several comorbidity-specific drugs became available in the past decade, most of these therapies are studied in relatively small cohorts using surrogate end-points. Therefore, larger studies are needed to address whether treating these comorbidities will improve patient outcome in chronic HF.

Keywords: Heart failure; anemia; comorbidities; diabetes mellitus; folic acid; hematinics; hyperkalemia; iron deficiency; vitamin B12.

Publication types

  • Review

MeSH terms

  • Anemia / diagnosis
  • Anemia / drug therapy*
  • Anemia / epidemiology
  • Chronic Disease
  • Comorbidity
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / epidemiology
  • Drug Therapy, Combination
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy*
  • Heart Failure / epidemiology
  • Hematinics / administration & dosage
  • Humans
  • Hyperkalemia / diagnosis
  • Hyperkalemia / drug therapy*
  • Hyperkalemia / epidemiology
  • Hypoglycemic Agents / administration & dosage

Substances

  • Hematinics
  • Hypoglycemic Agents