Heart Failure Drugs Still Underused in US Practices, Study Finds

In a retrospective cohort study recently published in JAMA Cardiology, researchers evaluated the rate of prescriptions for sodium-glucose cotransporter 2 inhibitors (SGLT2i) provided to patients with heart failure (HF) in outpatient cardiovascular care practices in the US.

Nearly 760,000 patients with HF were seen from July 1, 2019, through June 30, 2023, at 191 practices across the US. The average age was 70 years, and almost half were women. Only about one in ten of these patients was given a prescription for an SGLT2i .

Of  patients with HF who had ejection fraction (EF) data available,17.9% with reduced EF and 8.9% with mildly reduced or preserved EF received a prescription for an SGLT2i. During the study period, prescription rates increased from 4.6% to 16.2% for all patients with HF, from 5.1% to 28.5% for those with reduced EF, and from 4.5% to 12.8% for those with mildly reduced or preserved EF (P for trend <0.001). Older adults, women, and patients with higher systolic BP were less likely to receive a prescription. People with type 2 diabetes were much more likely to receive a prescription. The use of this treatment for patients with HF varied greatly among clinics, even after accounting for patient and practice differences.

Although SGLT2i therapy is known to benefit patients with HF, it is not being used widely or consistently in US practices. The authors conclude that efforts should be made to improve the use of SGLT2i therapy for ambulatory patients with HF in the US.