SGLT‐2 Inhibitors in Heart Failure: Current Management, Unmet Needs, and Therapeutic Prospects

Heart failure (HF) is a growing public health issue. As many as 1 in 5 people are expected to develop HF during their lifetime, 1 with an estimated 63 million people affected worldwide. 2 In 2012 HF was responsible for an estimated health expenditure of 31 billion USD, a figure anticipated to see an increase of 127% by 2030. 3 The increasing burden of HF on health care is primarily due to an aging population, as evidenced by the predominance of HF as a cause of hospitalization in individuals aged over 65 years. 4 HF comprises an array of patients categorized by their symptoms and ejection fraction (EF), including those with reduced EF (EF 50%; HFpEF). 5 Recent trends indicate that the prevalence of HFpEF is increasing relative to HFrEF, with estimates suggesting that 65% of patients with HF will have an EF>40% by 2020. 4 Here, we review the current unmet needs in the management of HF and discuss how these needs may be addressed, focusing on the potential role of sodium‐glucose cotransporter‐2 (SGLT‐2) inhibitors.