AHA Releases Comprehensive List of Drugs That Could Cause Heart Failure

The American Heart Association has published a list of prescription drugs that may cause or exacerbate heart failure (HF).

The scientific statement was “designed to serve as a comprehensive and accessible source of drugs that may cause or exacerbate heart failure to assist healthcare providers in improving the quality of care for these patients.”
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The authors cite the high medication burden of HF patients and the potential for adverse drug events and drug-drug interactions as leading reasons for constructing the list.

“Drugs may cause or exacerbate HF by causing direct myocardial toxicity; by negative inotropic, lusitropic, or chronotropic effects; by exacerbating hypertension; by delivering a high sodium load; or by drug-drug interactions that limit the beneficial effects of HF medications. To avoid these negative effects, healthcare providers need a comprehensive and accessible guide of the prescription medications, OTC medications, and CAMs that could exacerbate HF,” the authors wrote.

The list was constructed using data from case reports, case series, package inserts, meta-analyses, and prospective and observational trials.

In addition to the list of drugs, the statement also includes a list of 9 considerations for minimizing polypharmacy and improving drug safety, including:

  • Conduct comprehensive medication reconciliation at each clinical visit.
  • Consider combination medications when possible and affordable.
  • Limit the use of as-needed medications to only those that are absolutely necessary.
  • Educate patients on the use of over-the-counter medications.

View the full scientific statement here.

—Michael Potts

Page RL, O’Bryant CL, Cheng D, et al. Drugs that may cause or exacerbate heart failure: a scientific statement from the American Heart Association [published online July 11, 2016]. Circulation. doi:10.1161/CIR.0000000000000426.