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Editorial Comment|Articles in Press

Doing Harm by Doing No Harm? Resisting the Urge to Retire GDMT in Older Adults With Heart Failure

Published:February 23, 2023DOI:https://doi.org/10.1016/j.cardfail.2023.02.006
      The most recent projections suggest that the prevalence of heart failure with reduced ejection fraction (HFrEF) will dramatically expand as the United States’ population ages.
      • Tsao CW
      • Aday AW
      • Almarzooq ZI
      • Anderson CAM
      • Arora P
      • Avery CL
      • et al.
      Heart Disease and Stroke Statistics-2023 Update: a report from the American Heart Association.
      Two decades have past since the benefit of the original pillars of guideline-directed medical therapy (GDMT), beta-blockers (BBs) and renin angiotensin system inhibitors (RASis) was first established in patients with HFrEF. Since then, the supportive data and armamentarium of therapies have only grown.
      • Dargie HJ.
      Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomised trial.
      • Packer M
      • Fowler MB
      • Roecker EB
      • et al.
      Effect of carvedilol on the morbidity of patients with severe chronic heart failure: results of the carvedilol prospective randomized cumulative survival (COPERNICUS) study.
      • Fagerburg B
      and the MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF).
      • Latini R
      • Masson S
      • Anand I
      • et al.
      Effects of valsartan on circulating brain natriuretic peptide and norepinephrine in symptomatic chronic heart failure: the Valsartan Heart Failure Trial (Val-HeFT).
      • Yusuf S
      • Pitt B
      • Davis CE
      • Hood Jr, WB
      • Cohn JN
      Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions.
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