As heart failure patients age, the number of medications they take can often increase, especially after a hospitalization. A recent study looked at the number of prescriptions these patients take, and the risks associated with taking that many drugs. 

In an article published in Circulation, researchers noted that hospitalized patients can be prescribed more than 10 medications as part of their treatment. 

“High medication burden, also known as polypharmacy, is commonly associated with adverse events and reactions,” said senior study author Parag Goyal, MD, MSc, of New York-Presbyterian/Weill Cornell Medical Center, in a release on the study. “As the treatment options for various conditions, including heart failure expand and the population ages, it is becoming increasingly important to weigh the risks and possible benefits of multiple medications.” 

The researchers noted that polypharmacy has been connected with a wide range of adverse outcomes, including falls, disability, and hospitalizations, especially for heart failure patients, who are described as “particularly vulnerable to the adverse effects of polypharmacy due to age-related alterations in pharmacokinetics and pharmacodynamics.” 

The research studied the charts of 558 patients all over the age of 65 who had been hospitalized with heart failure over more than a decade at more than 300 hospitals across the country. 

The medications were measured at admission and discharge and divided into several categories based on the conditions they treat, including heart failure, coronary heart disease, and other non-heart-related drugs. 

In their findings, the researchers noted 84% of the patients were prescribed at least five medications, while 42% were prescribed at least 10. The data also showed patients who were hospitalized for heart failure were often discharged with more prescriptions than they had at the time of admission. 

However, most of the medications the patients took were for non-cardiovascular conditions. 

The most commonly initiated medications included loop diuretics, beta-blockers, aspirin, and electrolyte supplements. 

The authors noted that polypharmacy has become more prevalent in recent years, “reflecting an urgent need to develop new strategies for managing high medication burden.” 

“The medication for older adults with heart failure was higher following a heart failure hospitalization. Some of these drugs may be appropriate,” Goyal added.  “However, our prior work has shown that many patients are discharged with prescriptions for medications that can worsen heart failure. This supports the ongoing need for improved and routine medication review processes prior to hospital discharge, and particularly in the immediate post-discharge period where the risk of hospital readmission is particularly high.”