{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T23:23:41Z","timestamp":1780529021472,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Heart failure (HF) affects more than 6 million adults in the United States, contributing to substantial morbidity, mortality, and health care costs. Despite advances in medical care, many medications can exacerbate HF, yet their prevalence of use remains unknown. This study examined the national use of prescription medications that could exacerbate HF in adults with self\u2010reported HF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed data from US adults with self\u2010reported HF in the National Health and Nutrition Examination Survey (NHANES) from 2011 to March 2020. Medications known to exacerbate HF, identified from HF guidelines, were documented through pill bottle reviews. Weighted estimates were used to calculate prevalence overall and by sex, race and ethnicity, and level of evidence for avoidance. Multivariable logistic regression models calculated adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for the use of these high\u2010risk medications by sex and race and ethnicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 687 participants, representing 5.2 million U.S. adults with HF after applying sampling weights, were included (mean age, 66.1 [95% CI 64.9, 67.4] years; 50.4% female [95% CI 45.9%, 55.0%]). Overall, 14.5% (95% CI 10.4%, 19.5%; <jats:italic>n<\/jats:italic>\u2009=\u200992) of adults with HF were prescribed at least one medication known to exacerbate HF, with the most common being diltiazem, meloxicam, and ibuprofen. Use of these medications was not significantly different by sex nor by race and ethnicity. Of these medications, 21.7% (95% CI 10.7%, 38.8%) had level A evidence warning against use, and 78.3% (95% CI 61.2%, 89.3%) had B level evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Over one\u2010seventh of U.S. adults with HF were likely to have been prescribed medications that could exacerbate the condition, underscoring the need to optimize care. Reducing high\u2010risk medication use may mitigate HF exacerbations and improve outcomes in this vulnerable population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.4648","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T07:32:16Z","timestamp":1737358336000},"page":"155-160","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence of prescription medication use that can exacerbate heart failure among US adults with heart failure"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5578-782X","authenticated-orcid":false,"given":"Alexander R.","family":"Zheutlin","sequence":"first","affiliation":[{"name":"Division of Cardiology, Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9621-9060","authenticated-orcid":false,"given":"Joshua A.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Intermountain Healthcare Department of Population Health Sciences, Spencer Fox Eccles School of Medicine University of Utah  Salt Lake City Utah USA"},{"name":"Department of Pharmacy, University of Utah Health University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4702-7465","authenticated-orcid":false,"given":"Joshua D.","family":"Niforatos","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine The Johns Hopkins University School of Medicine  Baltimore Maryland 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PA","year":"2022","journal-title":"Circulation"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000950"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2023.07.006"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2021.09.004"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.08.007"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15654"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000426"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00947-1"},{"key":"e_1_2_8_10_1","unstructured":"NHANES.Survey Methods and Analytic Guidelines.2023https:\/\/wwwn.cdc.gov\/nchs\/nhanes\/analyticguidelines.aspx"},{"key":"e_1_2_8_11_1","unstructured":"NHANES.National Health and Nutrition Examination Survey 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