ArticleJournal of the American Heart Association2022
Adherence and Discontinuation of Optimal Heart Failure Therapies According to Age: A Danish Nationwide Study.
Article in Journal of the American Heart Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- The effect of down-titration and discontinuation of heart failure pharmacotherapy in older people: A systematic review and meta-analysis.British journal of clinical pharmacology · 2025Pooled it
- Patterns of Evidence-Based Medication Use in Older Adults with Chronic Heart Failure in Slovakia: A Population-Based Study Using the National Health Information Center Database.Drugs & aging · 2026Article
- Heart failure burden and care among cardiology inpatients: insights from the Hellenic Cardiorenal Morbidity Snapshot (HECMOS) study.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Cytochrome P450 2D6 Metabolizer Phenotype Is Associated With Metoprolol Pharmacodynamics But Not With Metoprolol Discontinuation: A Retrospective Cohort Study in the All of Us Research Program.Journal of clinical medicine research · 2026Article
- Care and Outcomes of New-Onset Heart Failure Across Vulnerable Populations: Temporal Trends in Mortality and Treatment in a Danish Nationwide Cohort From 2003 to 2022.Journal of the American Heart Association · 2026Article
- Utility of the mini-mental state examination for assessing cognitive function in determining appropriate medication management strategies in patients with heart failure: a retrospective observational study.Journal of pharmaceutical health care and sciences · 2026Article
- The impact of social support on medication adherence among patients with heart failure: health literacy as a mediator.Scientific reports · 2026Article
- Heart Failure Phenotypes Across Age Groups in the Danish Administrative Registers.Clinical epidemiology · 2026Article
- Clinical Pharmacology of Heart Failure in Frailty.European cardiology · 2026Review
- Cardiac resynchronization therapy for enabling guideline-directed medical therapy optimization in heart failure.European journal of heart failure · 2025Article
- Adverse Drug Events Associated with Optimizing Heart Failure Pharmacotherapy in Older Adults with Frailty: A Qualitative Study.CJC open · 2025Article
- Tolerability and Adverse Effects in a Specialized Heart Failure Guideline-Directed Medical Therapy Optimization Program.Clinical cardiology · 2025Article
- Review
- Prevalence of heart failure pharmacotherapy utilisation, frailty and adverse drug events among hospitalised adults older than 75 years: a multicentre cross-sectional study.Internal medicine journal · 2025Article
- Improving Medication Adherence in Heart Failure Through Pharmacist-Led Patient Education: Protocol for a Mechanism-Based Study of Information, Motivation, and Behavioral Skills.Patient preference and adherence · 2025Article
- Discontinuation rates, clinical effects and provocation factors of SGLT-2 inhibitor in the real world.Scientific reports · 2024Article
- Sodium Zirconium Cyclosilicate for Renin-Angiotensin-Aldosterone System Inhibitor Optimization in Patients with Heart Failure with Reduced Ejection Fraction: A Retrospective Analysis.Cardiology and therapy · 2024Article
- Assessment of adherence to treatment recommendations among patients with heart failure: a cross-sectional study.BMC cardiovascular disorders · 2024Article
- Adherence to drug therapy in patients with heart failure associated with reduced ejection fractions (HFrEF) during cardiac rehabilitation and after 3 and 6 months.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Article
- How to Manage Beta-Blockade in Older Heart Failure Patients: A Scoping Review.Journal of clinical medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Guideline-recommended disease-modifying pharmacological therapies for heart failure (HF) with reduced ejection fraction are underutilized, particularly among elderly patients. We studied the association of age in adherence and discontinuation of angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers (ACEi/ARB), β-blockers (BB), and mineralocorticoid receptor antagonists. Methods and Results Patients with a first heart failure diagnosis who had initiated ACEi/ARB and BB within 120 days of presentation were included from nationwide registries and divided into 3 age groups: <65 years (reference), 65 to 79, and ≥80. One-year median proportions of daily target doses were calculated. Adherence was estimated by the proportion of days covered. The 5-year risk of discontinuation was assessed with the Aalen-Johansen estimator. Discontinuation rates were evaluated using Multivariable Cox regression. Twenty-nine thousand four hundred eighty-two patients were included. Advancing age was associated with lower median proportions of daily target doses and adherence (ACEi/ARB 79.1%, 77.5%, and 69.4%; BB 79.1%, 78.6%, and 73.8%), in the <65, 65 to 79, and ≥80 age groups, respectively. Age ≥80 was associated with higher discontinuation rates (cumulative incidence, ACEi/ARB 41%, 44%, and 51%; BB 38%, 35%, and 39%; hazard ratio, ACEi/ARB 1.60 [95% CI, 1.51-1.69]; BB 1.33 [95% CI, 1.25-1.41]). The risk of mineralocorticoid receptor antagonists discontinuation differed little with age (50%, 54%, and 56%), although mineralocorticoid receptor antagonists initiation in the most elderly was less frequent (33%, 33%, and 22%). Conclusions In a nationwide cohort of patients with heart failure, advanced age was associated with lower proportions of daily target doses, lower adherence, and higher discontinuation rates of ACEi/ARB and BBs. Focus on treatment adherence and optimal dosages among elderly patients with heart failure could improve outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.