<![CDATA[Background: Cardiovascular disease remains one of the leading causes of morbidity and mortality worldwide, including in Indonesia. Patients with cardiovascular disease, particularly those with heart failure, commonly present with multiple comorbidities such as hypertension, diabetes mellitus, chronic kidney disease, dyslipidemia, atrial fibrillation, and psychological disorders. These conditions often require the concurrent use of multiple medications that are clinically indicated and guideline based, however it may also increase the risk of drug interactions, adverse drug reactions, poor adherence, and treatment burden. Objective: This narrative review aims to examine the polypharmacy in patients with cardiovascular disease, particularly heart failure, including its definition, prevalence, contributing factors, clinical impacts, management strategies. Results: Polypharmacy is commonly defined as the concurrent use of five or more medications. Polypharmacy is highly prevalent among patients with heart failure, especially older adults and those with multiple comorbidities. The impact of polypharmacy is not always negative, as some medications, such as guideline-directed medical therapy, have been shown to improve prognosis in patients with heart failure. However, inappropriate polypharmacy may increase the risk of potentially inappropriate medications, therapeutic competition, drug interactions, adverse drug reactions, hospitalization, reduced quality of life, and medication non-adherence. Management strategies include medication review, medication reconciliation, medication therapy management, deprescribing, and multidisciplinary collaboration among physicians, pharmacists, and other healthcare professionals. Conclusion: Polypharmacy is a common condition among patients with cardiovascular disease, particularly those with heart failure. Its management should be individualized, systematic, multidisciplinary, and patient-centered. The primary focus should not merely be reducing the number of medications, but ensuring that each medication is appropriately indicated, safe, effective, and provides benefits that outweigh its risks. Keywords: polypharmacy, cardiovascular disease, heart failure, medication review, deprescribing.]]>
Copyrights © 2026
