Pharmacotherapy for co-morbidities in chronic heart failure: a focus on hematinic deficiencies, diabetes mellitus and hyperkalemia

INTRODUCTION: Chronic heart failure (HF) is frequently accompanied by one or more co-morbidities. The presence of co-morbidities in chronic HF is strongly correlated to HF severity and impaired outcome.

AREAS COVERED: This review will address several co-morbidities with high prevalence and/or high impact in patients with chronic HF, including diabetes, anemia, hematinic deficiencies, and hyperkalemia. The background and subsequent pharmacotherapeutic options of these co-morbidities will be discussed. For this review, a MEDLINE search was performed.

EXPERT OPINION: Heart failure is increasingly considered a multimorbid syndrome, including metabolic derangements and chronic inflammation. Persistent metabolic derangements and low-grade inflammation might lead to progression of HF and the development of co-morbidities. Although several co-morbidity-specific drugs became available in the past decade, most of these therapies are studied in relatively small cohorts using surrogate end-points. Therefore, larger studies are needed to address whether treating these co-morbidities will improve patient outcome in chronic HF.