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Current dietary recommendations for patients with heart failure (HF) are largely based on data from non-HF populations; evidence on associations of dietary patterns with outcomes in HF is limited. We therefore evaluated associations of Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diet scores with mortality among postmenopausal women with HF.Women’s Health Initiative participants were followed up from the date of HF hospitalization through the date of death or last participant contact before August 2009. Mediterranean and DASH diet scores were calculated from food-frequency questionnaires. Cox proportional hazards models adjusted for demographics, health behaviors, and health status were used to calculate hazard ratios and 95% confidence intervals (CI). For a median of 4.6 years of follow-up, 1385 of 3215 (43.1%) participants who experienced a HF hospitalization died. Multivariable-adjusted hazard ratios were 1 (reference), 1.05 (95% CI, 0.89-1.24), 0.97 (95% CI, 0.81-1.17), and 0.85 (95% CI, 0.70-1.02) across quartiles of the Mediterranean diet score (P trend=0.08) and 1 (reference), 1.04 (95% CI, 0.89-1.21), 0.83 (95% CI, 0.70-0.98), and 0.84 (95% CI, 0.70-1.00) across quartiles of the DASH diet score (P trend=0.01). Diet score components, vegetables, nuts, and whole grain intake, were inversely associated with mortality.Higher DASH diet scores were associated with modestly lower mortality in women with HF, and there was a nonsignificant trend toward an inverse association with Mediterranean diet scores. These data provide support for the concept that dietary recommendations developed for other cardiovascular conditions or general populations may also be appropriate in patients with HF.URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000611. [ABSTRACT FROM AUTHOR]

The article discusses a meta-analysis of prospective studies that assess the relation between habitual coffee consumption and the risk of heart failure. The details including author, year of publication and geographic location of study were recorded for each study and information about the levels of coffee intake were obtained. It suggests a J-shaped relationship between coffee consumption and heart failure occurrence with a modest inverse association with moderate consumption.

The article presents information study which examined the relationship between coffee consumption of women and the incidence of heart failure. The study was conducted among women ages 48 to 83 who were participants of the Swedish Mammography Cohort and do not have heart failure, diabetes or myocardial infarction at baseline. Results reportedly show that there is no connection between women's coffee consumption and the incidence of heart failure.

The article discusses a study on the role of chocolate consumption in treating heart failure (HF). The study is conducted through a survey involving 31,823 female adults within the 48-83-year age range without any major cardiovascular conditions. The study concluded that women who consume 1 to 3 servings of chocolate a month increases the chances of avoiding hospitalization and death, the possible risks caused by HF.

The article discusses a study which examines the strength of association between body mass index (BMI) and heart failure (HF). The study found that people with BMI between 25 and 30 kilograms per meter-squared are at risk of developing heart diseases regardless of waist circumference (WC). The study also assessed that the strength of association between BMI and HF decreases with regards to age, while WC is associated with HF at all levels of BMI in women.

Supplemental Digital Content is available in the text. Background: It is not known which social determinants of health (SDOH) impact 30-day readmission after a heart failure (HF) hospitalization among older adults. We examined the association of 9 individual SDOH with 30-day readmission after an HF hospitalization. Methods and Results: Using the REGARDS study (Reasons for Geographic and Racial Differences in Stroke), we included Medicare beneficiaries who were discharged alive after an HF hospitalization between 2003 and 2014. We assessed 9 SDOH based on the Healthy People 2030 Framework: race, education, income, social isolation, social network, residential poverty, Health Professional Shortage Area, rural residence, and state public health infrastructure. The primary outcome was 30-day all-cause readmission. For each SDOH, we calculated incidence per 1000 person-years and multivariable-adjusted hazard ratios of readmission. Among 690 participants, the median age was 76 years at hospitalization (interquartile range, 71–82), 44.3% were women, 35.5% were Black, 23.5% had low educational attainment, 63.0% had low income, 21.0% had zip code–level poverty, 43.5% resided in Health Professional Shortage Areas, 39.3% lived in states with poor public health infrastructure, 13.1% were socially isolated, 13.3% had poor social networks, and 10.2% lived in rural areas. The 30-day readmission rate was 22.4%. In an unadjusted analysis, only Health Professional Shortage Area was significantly associated with 30-day readmission; in a fully adjusted analysis, none of the 9 SDOH were individually associated with 30-day readmission. Conclusions: In this modestly sized national cohort, although prevalent, none of the SDOH were associated with 30-day readmission after an HF hospitalization. Policies or interventions that only target individual SDOH to reduce readmissions after HF hospitalizations may not be sufficient to prevent readmission among older adults. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is available in the text. Background: Despite potential harm that can result from polypharmacy, real-world data on polypharmacy in the setting of heart failure (HF) are limited. We sought to address this knowledge gap by studying older adults hospitalized for HF derived from the REGARDS study (Reasons for Geographic and Racial Differences in Stroke). Methods: We examined 558 older adults aged ≥65 years with adjudicated HF hospitalizations from 380 hospitals across the United States. We collected and examined data from the REGARDS baseline assessment, medical charts from HF-adjudicated hospitalizations, the American Hospital Association annual survey database, and Medicare's Hospital Compare website. We counted the number of medications taken at hospital admission and discharge; and classified each medication as HF-related, non-HF cardiovascular-related, or noncardiovascular-related. Results: The vast majority of participants (84% at admission and 95% at discharge) took ≥5 medications; and 42% at admission and 55% at discharge took ≥10 medications. The prevalence of taking ≥10 medications (polypharmacy) increased over the study period. As the number of total medications increased, the number of noncardiovascular medications increased more rapidly than the number of HF-related or non-HF cardiovascular medications. Conclusions: Defining polypharmacy as taking ≥10 medications might be more ideal in the HF population as most patients already take ≥5 medications. Polypharmacy is common both at admission and hospital discharge, and its prevalence is rising over time. The majority of medications taken by older adults with HF are noncardiovascular medications. There is a need to develop strategies that can mitigate the negative effects of polypharmacy among older adults with HF. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is available in the text. Background: US guidelines recommend that patients with heart failure with reduced ejection fraction (HFrEF), who tolerate an ACEI (angiotensin-converting enzyme inhibitor) or ARB (angiotensin II receptor blocker), be switched to sacubitril/valsartan to reduce morbidity and mortality. We compared characteristics and healthcare utilization between Veterans with HFrEF who were switched to sacubitril/valsartan versus maintained on an ACEI or ARB. Methods: retrospective cohort study of treated HFrEF (July 2015–June 2017) using Veterans Affairs data. The index date was the first fill for sacubitril/valsartan and if none, for an ACEI or ARB. Treated HFrEF was defined by (1) left ventricular ejection fraction ≤40%, (2) ≥1 in/outpatient HF encounter, and (3) ≥1 ACEI or ARB fill, all within 1-year preindex. Poisson regression models were used to compare baseline characteristics and 1:1 propensity score-matched adjusted 4-month follow-up healthcare utilization between sacubitril/valsartan switchers and ACEI or ARB maintainers. Results: Switchers (1612; 4.2%) were less likely than maintainers (37 065; 95.8%) to have a history of myocardial infarction or hypertension, and more likely to be black, have a lower left ventricular ejection fraction, and higher preindex healthcare utilization. Switchers were less likely to experience follow-up all-cause hospitalizations (11.2% versus 14.0%; risk ratio 0.80 [95% CI, 0.65–0.98], P value 0.035). Conclusions: Few Veterans with treated HFrEF were switched to sacubitril/valsartan within the first 2 years of Food and Drug Administration approval. Sacubitril/valsartan use was associated with a lower risk for all-cause hospitalizations at 4 months follow-up. Reasons for lack of guideline-recommended sacubitril/valsartan initiation warrant investigation and may reveal opportunities for HFrEF care optimization. [ABSTRACT FROM AUTHOR]

The authors reflect on the study of M. D. Witham and colleagues which examines the potential of vitamin D supplementation to improve body functions and quality of life in older patients with heart failure. The authors argue that despite the complete walk test of the participant, the ability of vitamin D to improve body functions and quality of life of the patients were not suggested. They also believe that the dose of vitamin D in the study were too low to see its benefits in the patients.