[Heart failure in Germany: epidemiology and recent developments].

Heart failure is the leading single cause of hospitalisation in Germany and places a heavy clinical and psychosocial burden on patients, families, and caregivers. Since 2021, evidence‑based management of heart failure with reduced ejection fraction (HFrEF) has centred on four pharmacological "pillars": β‑blockers, sacubitril/valsartan (or an ACE inhibitor), mineralocorticoid‑receptor antagonists, and sodium-glucose co‑transporter‑2 (SGLT‑2) inhibitors. While these agents improve survival and quality of life, they also predispose to adverse effects - most notably electrolyte disturbances. Hypo‑ or hyperkalaemia can precipitate malignant arrhythmias and therefore demands vigilant monitoring. Iron deficiency is equally prevalent in the heart‑failure population; randomised trials have primarily tested intravenous iron(III)‑carboxymaltose and iron(III)‑derisomaltose to correct this deficit. This review summarises the most recent epidemiological data for heart failure in Germany and Europe, outlines current guideline‑directed therapies, and highlights key treatment‑related complications clinicians must anticipate and manage.