American Journal of Cardiovascular Drugs

, Volume 15, Issue 3, pp 171–184 | Cite as

Managing Comorbidities in Patients with Chronic Heart Failure: First, Do No Harm

  • Beth DeJongh
  • Kade Birkeland
  • Michael BrennerEmail author
Review Article


Heart failure (HF) affects approximately 5.1 million adults in the USA, with expectations of a rise to nearly 8 million adults by 2030. Patients with HF are at increased risk for morbidity/mortality, and comorbidities can further complicate care for these patients. Diabetes mellitus, chronic pain, arrhythmias, and depression are diagnoses that often coexist with HF. Medications commonly used to treat these comorbidities may induce or worsen HF symptoms, so determining appropriate drug therapy is important. Healthcare providers must understand the relationship between these medications and HF in order to improve prescribing practices to increase patient safety and reduce morbidity and mortality. This manuscript discusses the association between certain medications used to treat the aforementioned diagnoses and their relationship to HF. The purpose of this article is to provide guidance on which pharmacologic options require special consideration, increased monitoring, or complete avoidance in HF patients with diabetes mellitus, chronic pain, arrhythmias, and/or depression.


Heart Failure Metformin Heart Failure Patient Carvedilol Pregabalin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No external funding was used in the preparation of this manuscript. None of the authors have any potential conflict of interest that might be relevant to the contents of this review.


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Copyright information

© Springer International Publishing Switzerland (outside the USA) 2015

Authors and Affiliations

  1. 1.Pharmacy Practice, Concordia University Wisconsin School of PharmacyMequonUSA
  2. 2.Clinical Pharmacy ServicesCedars Sinai Health AssociatesBeverly HillsUSA
  3. 3.VA Ann Arbor Healthcare SystemAnn ArborUSA

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