Heart failure & cardiomyopathies
Cardiovascular risk associated with polypharmacy in heart failure: a systematic review and meta-analysis
Authors' conclusion
Polypharmacy in patients with HF was associated with increased risk of composite CV outcome and HF hospitalization, reflecting the complexity of managing multiple medications. These findings underscore the need for individualized medication reviews to minimize inappropriate prescribing and ensure continued delivery of evidence-based therapies.
Study context
- Population
- Patients with heart failure (HF)
- Participants
- 30,115 patients10 studies
- Comparison
- Effect estimates, based on comparisons between the highest and lowest levels of polypharmacy
- Outcome
- Composite:
- Cardiovascular (CV) endpoint
- Its individual components
Methodological detailsrandom-effects models
- Random-effects models
Pooled result
As reported in the abstract
polypharmacy vs without polypharmacyHazard ratio (95% CI)
Composite CV endpoint
1.27(1.15–1.39)
HF hospitalization
1.42(1.28–1.56)
CV death; no significant association
1.07(0.81–1.41)
All-cause mortality; no significant association
1.05(0.88–1.25)
Original publication
Cardiovascular risk associated with polypharmacy in heart failure: a systematic review and meta-analysis. ESC Heart Fail. Published 23 January 2026. doi:10.
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