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In contrast, calcium channel blockers were prescribed more frequently in geriatricpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Message<\/jats:title>\n                    <jats:p>Older individuals with heart failure appear to be undertreated with evidence-based therapies, highlightingage-related gaps in guideline-concordant care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Germany, heart failure (HF) is the most common diagnosis in hospitalized patients. Its prevalence rises significantly with age. In addition, age-related conditions, such as hypertension, coronary artery disease, obesity, and diabetes mellitus, contribute to an elevated risk of heart failure. It is assumed that older patients are more likely to receive treatment that does not conform to the guidelines because of frequent comorbidities, such as chronic renal disease and pre-existing polypharmacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data from a prospective cohort study on chronic HF (MyoVasc study,\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20093289; NCT04064450), were analyzed. Participants underwent a 5-h highly standardized examination, including assessment of medication with subsequent categorization according to the anatomical therapeutic chemical (ATC) coding system. Study participants were categorized as older adults aged\u2009\u2265\u200970\u00a0years and subsequently compared to younger adults regarding frequency of medication intake. Poisson regression with robust standard errors with adjustment for age, sex, cardiovascular risk factors, comorbidities, and kidney function was used to analyze medication intake by age status in subjects with chronic HF stages C\/D.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analyzed sample comprised 1281 older adults (mean age: 75.4\u2009\u00b1\u20093.6\u00a0years, 33.1% women, 66.9% men) and 2,008 younger adults (mean age: 57.7\u2009\u00b1\u20098.5\u00a0years, 35,2% women, 64.8% men). A total of 68.5% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009878) of the older individuals presented with HF stage C\/D, compared to 43% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009863) in younger adults. On average, older individuals took 6.53 (standard deviation (SD)\u2009\u00b1\u20093.14) drugs as compared to younger participants taking 4.65 (SD\u2009\u00b1\u20093.45) drugs regardless of the severity of HF. Poisson regression analysis demonstrated that older individuals received aldosterone antagonists less frequently (Prevalence Ratio (PR): 0.64, 95%CI 0.54; 0.77,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). This effect persisted after additional adjustment for kidney function (PR: 0.53, 95%CI 0.44; 0.63,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Beta-blockers were used significantly less frequently in older adults compared to younger adults (PR: 0.93, 95%CI 0.88; 0.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016). In contrast, calcium channel blockers were prescribed significantly more often in the older group (PR: 1.22, 95%CI 1.01; 1.48,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035). Additionally, older adults with impaired renal function received loop diuretics less frequently (PR: 0.88, 95%CI 0.78; 0.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The present study identified age-related disparities in the use of guideline-based therapy for heart failure. These differences persisted even after adjusting for renal dysfunction, a common and relevant comorbidity in the aged population. These findings suggest a potential underutilization of evidence-based heart failure therapies in older individuals with heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registry<\/jats:title>\n                    <jats:p>NCT04064450<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s41999-026-01553-4","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T10:01:57Z","timestamp":1784023317000},"page":"2087-2097","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age-related differences in the intake of heart failure therapy among participants from the MyoVasc study"],"prefix":"10.1007","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct04064450","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Michael","family":"Mohr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silav","family":"Zeid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Buch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Rausch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Velmeden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawad","family":"Kazemi-Asrar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Foo\u00df","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl J.","family":"Lackner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Gori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Lurz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen H.","family":"Prochaska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Hardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4413-9752","authenticated-orcid":false,"given":"Philipp S.","family":"Wild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"issue":"10","key":"1553_CR1","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.1016\/j.cardfail.2023.07.006","volume":"29","author":"B Bozkurt","year":"2023","unstructured":"Bozkurt B, Ahmad T, Alexander KM, Baker WL, Bosak K, Breathett K et al (2023) Heart Failure Epidemiology and outcomes statistics: a report of the heart failure society of America. 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Circulation. 2020;141(5):352\u201361.","DOI":"10.1161\/CIRCULATIONAHA.119.044586"}],"container-title":["European Geriatric Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41999-026-01553-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s41999-026-01553-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41999-026-01553-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:24:52Z","timestamp":1789061092000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s41999-026-01553-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":36,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["1553"],"URL":"https:\/\/doi.org\/10.1007\/s41999-026-01553-4","relation":{},"ISSN":["1878-7657"],"issn-type":[{"value":"1878-7657","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"assertion":[{"value":"22 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 June 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"There are no conflicts of interest reported regarding this work. Outside the submitted work, P.S. Wild (PSW) reports grants from Bayer AG, non-financial grants from Philips Medical Systems, grants and consulting fees from Boehringer Ingelheim, grants and consulting fees from Novartis Pharma, grants and consulting fees from Sanofi-Aventis, grants, consulting and lecturing fees from Bayer Health Care, grants and consulting fees from Daiichi Sankyo Europe, lecturing fees from Pfizer Pharma, lecturing fees from Bristol Myers Squibb, consulting fees from Astra Zeneca, consulting fees and non-financial support from Diasorin and non-financial support from IEM. PSW is funded by the European Regional Development Fund and the Ministry of Science and Health of the State of Rhineland-Palatinate (EFRE\/REACT-EU, Grant No. 84007232 and No. 84009735), the Federal Ministry of Education and Research (BMBF 01EO1503, 81Z0210103, 81Z0210102, 03ZU1202AA, 03ZU1202CD, 03ZU1202DB, 03ZU1202JC, 03ZU1202KB, 03ZU1202LB, 03ZU1202MB, 03ZU1202OA), Ministry of Science and Health of the State of Rhineland Palatinate (MWG RLP 724\u20130010#2021\/0030\u20131501), the ReALity Initiative of the Life Sciences of the Johannes Gutenberg University Mainz for the establishment of a cell bank, the National Research Network University Medicine on COVID-19 (\u201dNaFoUniMedCovid19\u2033, Grant No. 01KX2021) B-FAST, and the Federal Institute for Occupational Safety and Health (BAuA, F2447 \/ 537727) outside the present work. PSW is principal investigator of the German Center for Cardiovascular Research (DZHK), principal investigator of the DIASyM research core (BMBF DIASyM research core (BMBF 161L0217A, 031L0217A, 16LW0241K), of the future cluster curATime (BMBF 03ZU1202AA, 03ZU1202CD, 03ZU1202DB, 03ZU1202JC, 03ZU1202KB, 03ZU1202LB, 03ZU1202MB, and 03ZU1202OA) and principal investigator of EPIC-AI (BMBF 01EQ2401A).","order":1,"name":"Ethics","label":"Conflicts of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All participants provided written consent prior to enrollment. The study protocol was assessed by relevant ethics committees before study initiation (\n                      Ethik-Kommission der Landes\u00e4rztekammer Rheinland-Pfalz\n                      , reference number 837.319.12 [8420-F]). All amendments to the study protocol that occurred later over the course of the study were also approved by the same instances. Compliance with the law was assessed by the data safety commissioner. The Declaration of Helsinki and the recommendations of Good Clinical Practice and Good Epidemiological Practice were thoroughly followed throughout the whole study. ClinicalTrials.gov ID: NCT04064450 (\n                      \n                      ).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all individual participants included in the study before study enrollment.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}}]}}