Polypharmacy is highly prevalent among patients with heart failure (HF), due to multimorbidity and guideline-directed pharmacotherapy. While polypharmacy aims to optimize management, it can increase the risk of drug-drug interactions and adverse drug events, which may compromise clinical outcomes. However, the evidence regarding the relationship between polypharmacy and cardiovascular (CV) outcomes in HF populations remains limited. The aim of this study was to determine the association between polypharmacy and adverse CV outcomes among patients with HF. A systematic review and meta-analysis were conducted to evaluate the association between polypharmacy and adverse CV outcomes in HF. Relevant studies were identified through searches of PubMed, Embase, and Web of Science. The primary outcomes included a composite CV endpoint and its individual components. Effect estimates, based on comparisons between the highest and lowest levels of polypharmacy, were pooled using random-effects models. Ten studies including 30 115 patients with HF were analyzed. Compared with those without polypharmacy, patients with polypharmacy had a significantly increased risk of the composite CV endpoint (HR: 1.27; 95% CI: 1.15-1.39). Notably, polypharmacy was linked to a higher risk of HF hospitalization (HR: 1.42; 95% CI: 1.28-1.56). No significant associations were found for CV death (HR: 1.07; 95% CI: 0.81-1.41) or all-cause mortality (HR: 1.05; 95% CI: 0.88-1.25). Polypharmacy in patients with HF was associated with increased risk of composite CV outcome and HF hospitalization, reflecting the complexity of managing multiple medications. These findings underscore the need for individualized medication reviews to minimize inappropriate prescribing and ensure continued delivery of evidence-based therapies. PROSPERO Registration Number CRD420251110556

Menopause is the natural period of aging in women induced by ovary deterioration, resulting in estrogen deficiency. We evaluated the antioxidative and anti-inflammatory properties of Cnidium officinale, Pueraria lobata Ohwi, and Leonurus japonicus (CPL) extracts on vascular endothelial dysfunction. After treatment, CPL extracts decreased serum lipid profiles, serum vasoactive substances, tail temperatures, and cardiovascular risk indices. In ovariectomized rats, vasodilation significantly increased, with an increase in endothelial nitric oxide synthase (eNOS) in the CPL200 and CPL500 groups compared with the OVX group (p < 0.05). The extracts also significantly reduced vascular cell adhesion protein 1 (VCAM-1) in the CPL50, CPL100, and CPL200 groups compared with the OVX group (p < 0.05, p < 0.01, and p < 0.001, respectively). Intercellular adhesion molecule 1 (ICAM-1) was also reduced in the CPL100 and CPL200 groups compared with the OVX group (p < 0.001 and p < 0.0001, respectively); this was achieved through the downregulation of the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and inducible nitric oxide (iNOS), which resulted in the synthesis of nuclear factor erythroid 2-related factor 2 (NRF2) and eNOS in HUVECs. Our results show that CPL extracts could provide cardioprotective effects against vascular endothelium dysfunction by decreasing inflammation and upregulating vasodilation, ascertained by evaluating the antioxidant systems of ovariectomized rats. Further studies are needed to explore the long-term cardioprotective effects.

Ahn S, et al. J Nutr Health. 2023 Dec;56(6):641-654. https://doi.org/10.4163/jnh.2023.56.6.641

Kim M, et al. Nutr Res Pract. 2026 Jun;20(3):359-381. https://doi.org/10.4162/nrp.2026.20.3.359

Epidemiologic evidence on the association between sugar-sweetened beverage (SSB) consumption and sleep-related symptoms or perceived stress remains limited, especially among middle-aged and older adults. This study examined the associations between SSB consumption and observed sleep apnoea, snoring, daytime tiredness and perceived stress among Korean adults aged 40 years and older. Cross-sectional data from the Korea National Health and Nutrition Examination Survey 2019–2023 were analysed ( n 17 255). SSB consumption was assessed via 24-h dietary recall and categorised as non-consumers, moderate consumers (Q1–Q3) and high consumers (Q4). Multivariable logistic regression with complex survey design adjustment was used to estimate OR and 95 % confidence intervals (CI). Among 17 255 participants (mean age 60·2 years, 57·5 % women), 10 169 (58·9 %) were SSB consumers. Compared with non-consumers ( n 7086), the highest intake group (Q4, n 2542) showed higher odds of observed sleep apnoea (OR 1·32; 95 % CI 1·09–1·60) and perceived stress (OR 1·23; 95 % CI 1·08–1·40). In sex-stratified analyses, the association with observed sleep apnoea was significant among men (OR 1·29; 95 % CI 1·04–1·60) but not women (OR 1·22; 95 % CI 0·89–1·67), although formal interaction analyses did not support significant effect modification by sex. Higher odds of perceived stress were observed in both men (OR 1·24; 95 % CI 1·02–1·50) and women (OR 1·22; 95 % CI 1·02–1·45). No significant associations were found for snoring or daytime tiredness. Higher SSB consumption was associated with observed sleep apnoea and perceived stress, and prospective studies are needed to clarify temporal relationships and underlying mechanisms.