TABLE 5.
Effect of Heart Failure-Targeted Therapies on Select Geriatric Conditions and Measures
| Effect on Select Geriatric Conditions |
Effect on Select Geriatric Measures |
||||||
|---|---|---|---|---|---|---|---|
| Malnutrition/Cachexia | Sarcopenia | Frailty | Cognitive Impairment | Functional Capacitya | Days Alive out of Hospital or Home Days | ADL | |
|
| |||||||
| Beta-adrenergic antagonists | Attenuates and causes partial reversal | No effect | Unknown | Unknown | Worse in HFpEF (better with withdrawal) Improved in HFrEF | Increased | Unknown |
| ACEI/ARB | Attenuates and causes partial reversal | Unknown | Unknown | No effect | Reduces rate of functional decline | Increased | Improved |
| ARNI | Unknown | Unknown | Unknown | No effect | Improved | Increased | Improved compared with ACEI |
| Hydralazine/nitrates | Unknown | Unknown | Unknown | Unknown | Improved | Increased | Unknown |
| MRAs | Unknown | Unknown | Unknown | Unknown | No effect or improved | Increased | Unknown |
| SGLT2i | Unknown | Unknown | Unknown | Improved | Improved | Increased | Unknown |
| GLP 1 RA | Unknown | Unknown | Unknown | Unknown | Improved | Unknown | Unknown |
| TTR stabilizer | Unknown | Unknown | Unknown | Unknown | Slows the decline | Increased | Unknown |
| Vericiguat | Unknown | Unknown | No effect | Unknown | Unknown | Increased | Unknown |
| Cardiac rehabilitation | Unknown | Improved | Improved | Improved | Improved | Unknown | Improved |
| Aerobic training | Unknown | Improved | Unknown | Improved | Improved | No effect | Unknown |
| Resistance training | Unknown | Improved | Unknown | Unknown | Improved | Unknown | Unknown |
| Posthospitalization | Unknown | Improved | Improved | Unknown | Improved | Unknown | Unknown |
| Cardiac resynchronization | Unknown | Unknown | Unknown | Improved | Improved | Increased | Unknown |
| Cardiac contraction modulation | Unknown | Unknown | Unknown | Unknown | Improved | Unknown | Unknown |
| Mitral valve clip | Unknown | Unknown | Unknown | Improved | Improved | Increased | Unknown |
| Baroreflex simulation | Unknown | Unknown | Unknown | Unknown | Improved | Unknown | Unknown |
a
Functional improvements include changes in NYHA functional class, peak oxygen consumption, or 6-minute walk time.
ACEI = angiotensin-converting enzyme inhibitor; ADL = activities of daily living; ARB = angiotensin receptor blocker; ARNI = angiotensin blocker-neprilysin inhibitor; GLP 1 RA = glucagon-like peptide 1 receptoragonist; HFpEF = heart failure with preserved ejection fraction; HFrEF = heart failure with reduced ejection fraction; MRA = mineralocorticoid receptor antagonist; SGLT2i = sodium glucose cotransporter 2 inhibitor; TTR = transthyretin.