Heart failure & cardiomyopathiesMeta-analysis

Cardiovascular risk associated with polypharmacy in heart failure: a systematic review and meta-analysis

ESC Heart FailPublished

  • systematic review and meta-analysis
  • random-effects models

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 Ten studies
Comparison
Effect estimates, based on comparisons between the highest and lowest levels of polypharmacy
Outcome
Composite:
  • Cardiovascular (CV) endpoint
  • Its individual components

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:10.1093/eschf/xvag005

Summarised from the published abstract; every number is checked against it