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April 1, 2026Journal of Cardiovascular Pharmacology and TherapeuticsOpen Access

Underuse of Guideline-Directed Medical Therapy Across Heart Failure Phenotypes in Older Outpatients: A Multicenter Cross-Sectional Study in Vietnam

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Why the study?

Heart failure is common among older adults, but data on phenotype distribution and real-world pharmacologic management remain limited.

What is the prevalence of and factors associated with GDMT underuse in older outpatients with heart failure in Vietnam?

Population

504 outpatients aged ≥60 years with HF in Vietnam

Comparison

HFrEF vs non-HFrEF phenotypes

Design

Multicenter cross-sectional study

Key result

Guideline-directed medical therapy underuse was prevalent among older outpatients in Vietnam, occurring in 49.8% of patients with HFrEF and 38.0% of those with non-HFrEF phenotypes.

Authors

HNHuan Thanh NguyenHNHuong Thi Mai NguyenKNKieu Dang Phuong Nguyen

Discussion

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Overview

Warrants heightened attention to GDMT optimization in HFrEF patients with COPD; extends underuse data to older Vietnamese outpatients.

Key Points

  • This study aims to assess the prevalence of guideline-directed medical therapy underuse across heart failure phenotypes in older outpatients in Vietnam.
  • Conducted a multicenter cross-sectional study with 504 outpatients aged ≥60 years
  • Classified patients into HFrEF, HFmrEF, and HFpEF phenotypes
  • Performed multivariable logistic regression to identify factors related to GDMT underuse
  • HFrEF accounted for 54.6%, HFmrEF 13.3%, and HFpEF 32.1% of patients
  • GDMT underuse observed in 49.8% of HFrEF and 38.0% of non-HFrEF patients
  • Hypertension decreased GDMT underuse in HFrEF (OR 0.38) while COPD increased it (OR 4.42)
  • Diabetes mellitus was linked to lower GDMT underuse in non-HFrEF (OR 0.52)

Study Design

Type

Cross-Sectional (n=504)

Multicenter

Yes

Structured PICO

What is the prevalence of and factors associated with GDMT underuse in older outpatients with heart failure in Vietnam?

P
Population
504 outpatients aged ≥60 years with heart failure (HFrEF n=275, HFmrEF n=67, HFpEF n=162)
O
Outcome
Prevalence of guideline-directed medical therapy (GDMT) underuse across HF phenotypes and factors associated with GDMT underuse

Main Result

Absolute Event Rate: 49.8% vs 38%

Guideline-directed medical therapy is underused in nearly half of older outpatients with HFrEF in Vietnam, with comorbidities like COPD further increasing the risk of undertreatment.

Cite This Study

Nguyen et al. (2026) conducted a cross-sectional in Heart failure (n=504). Guideline-directed medical therapy (GDMT) was evaluated on GDMT underuse. Guideline-directed medical therapy underuse was prevalent among older outpatients in Vietnam, occurring in 49.8% of patients with HFrEF and 38.0% of those with non-HFrEF phenotypes.

synapsesocial.com/papers/69cd7a615652765b073a7791https://doi.org/10.1177/10742484261438177
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