Deprescribing of beta-blocker and RAAS inhibitors in heart failure patients: A narrative review.

Background

There are four pillars in the treatment of heart failure. During treatment, heart failure patients generally require therapy adjustment, which was deprescribing practice. Aim: This review aimed to study outcomes from deprescribing of beta blockers and renin-angiotensin aldosterone system inhibitors (RAASIs) in heart failure patients.

Methods

A narrative review was carried out. The search was conducted in May 2025, using Pubmed, Cochrane Library, and Scopus. Eligible studies included randomized controlled trials (RCTs), observational studies, and retrospective studies. Interventions included deprescribing of guideline-directed medical therapy (GDMT), or beta blocker, or RAASIs. Only articles published in English between 2015 and 2025 were included in the search.

Results

The search and screening resulted in seven evaluable articles.

Conclusion

The current review shows that negative outcomes from deprescribing of beta blockers or RAASIs were dominant. Other measures were, therefore, needed to be taken into consideration for a better benefit/risk balance.