Could You Have Heart Failure?

| February 1, 2011

February is American Heart Month; join the fight against this life-threatening disease

Heart disease is the leading cause of death in the United States. About 630,000  Americans die each year of some form of heart disease — more than one in every four deaths.

With Wear Red Day on February 5, and American Heart Month being observed throughout the month, the media will be focusing on walks, marathons, fund-raisers and educational forums across Houston, the state and the nation. All these events are geared toward reminding people to have their blood pressure and cholesterol checked to make sure the ticker is in good shape. Without early identification, a heart attack may be the first sign anyone has that they have coronary artery disease. The Centers for Disease Control gives this advice for recognizing and treating heart failure:

Early identification — While the incidence of heart attack and stroke has gone down in recent years, heart failure is more common than ever. The number of people each year who are hospitalized by the condition — in which a damaged heart can’t pump enough blood to nourish the rest of the body — has more than doubled over the last three decades, to more than 1.1 million. And they often face a worse prognosis than many cancer patients.

But recent developments, including a new blood test that helps doctors diagnose the disease, have given heart-failure patients some good news.

Keep your heart strong — It’s particularly important to understand heart failure if you have any of the main risk factors for the disease: certain heart-valve disorders, diabetes, high blood pressure or cholesterol levels, an overactive thyroid gland, or a previous heart attack. All of those factors can prevent the heart from contracting forcefully enough to expel all the blood in its main pumping chamber, a condition known as systolic heart failure. Or the heart can become overly stiff, preventing the chamber from filling before it contracts. That’s diastolic heart failure, a slightly less common form that affects about 40 percent of patients.

Disease prevention — The first step toward avoiding heart failure is to make life­style changes: stop smoking, limit alcohol intake, lose excess weight, exercise and eat a heart-healthy diet. Equally important is getting screened regularly for conditions that can damage the heart, and then treating those problems when necessary. People with hypertension who control their blood pressure, for example, can cut their heart-failure risk in half.

If prevention doesn’t work, it’s best to detect heart failure early. But that’s easier said than done, because several common conditions — asthma, emphysema and even anemia — can cause some or all of the same early symptoms or signs. More­over, those early indications often develop so slowly, over months or even years, that they’re easily overlooked or discounted.

As a result, some doctors don’t think of the disease until they observe the classic objective signs, including swollen legs or belly, bulging neck veins, liver enlargement and abnormal heart or lung sounds. But that can be a deadly oversight because such signs often indicate more advanced disease. Now research shows that a simple blood test, which measures levels of a protein made by heart cells called B-type natriuretic peptide (BNP), can sometimes help to diagnose the disease earlier. And people with indications of possible heart failure should undergo echocardiography, or ultrasound imaging of the heart after other causes have been ruled out, even if they have none of the disease’s classic objective signs.

Lifestyle changes — Treating heart failure requires more than medication. In addition to making the same lifestyle changes that can prevent the disease, heart-failure patients should:

Avoid drugs that can worsen the condition. Those include painkillers such as ibuprofen (Advil and generic) and naproxen (Aleve and generic), as well as the anti-diabetes drugs pioglitazone (Actos) and rosiglitazone (Avandia).

Cut back on salt. A diet high in sodium causes the body to retain fluid, forcing the heart to pump harder.

Exercise regularly. Aerobic exercise, such as walking or cycling, can ease symptoms by improving the ability of the heart and lungs to supply the muscles with oxygen. Strength training can also help, by countering the muscle loss caused by disease-induced inactivity. Before starting, patients should consult their doctor and, ideally, a physical therapist because the proper program varies among patients.

If you or someone you know has heart disease, join a walk. If you think you might have heart disease, see your doctor. Don’t hide your head in the sand. Pay attention to February heart events and learn all you can about coronary artery disease and the damage it can do to your heath — and your life.

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