Preventing Heart Failure — A Serious and Increasingly Common Chronic Disease

Monday, June 20, 2011

ROCHESTER, Minn. — Heart failure happens when the heart can't pump enough blood to meet the body's needs. The American Heart Association says heart failure is a growing epidemic. The June issue of Mayo Clinic Health Letter covers some reasons for the increased prevalence of heart failure and options to help prevent it.

Heart failure often develops after the heart has been damaged or weakened by other conditions. The dramatic increase in heart failure coincides with an aging population, more people with heart disease and increased survival rates for those who experience heart attacks.

Over time, a heart that is compromised by underlying disease changes and loses function. The ventricles, the main pumping chambers, may become stiff and not fill properly between beats. The heart muscle may weaken. The ventricles can stretch, decreasing pumping efficiency. High blood pressure, faulty heart valves, abnormal heart rhythms, diabetes and other factors also can contribute to heart failure. Signs and symptoms of heart failure can include shortness of breath and leg swelling.

Medication may be necessary to treat underlying conditions that increase the risk of heart failure. There are many options, including:

• Angiotensin-converting enzyme (ACE) inhibitors — These medications relax the blood vessels to lower blood pressure, improve blood flow and decrease the heart's workload. Examples include enalapril (Vasotec), lisinopril (Prinivil, Zestril) and captopril (Capoten).
• Angiotensin II receptor blockers (ARBs) — ARBs offer many of the same benefits as ACE inhibitors and are an option when ACE inhibitors aren't well tolerated. Options include losartan (Cozaar), valsartan (Diovan) and others.
• Digoxin (Lanoxin) — This medication improves the strength of heart muscle contractions and tends to slow the heartbeat.
• Beta blockers — These drugs slow the heart rate, reduce blood pressure and may reduce the risk of some abnormal heart rhythms. Examples include bisoprolol (Zebeta), carvedilol (Coreg) and metoprolol (Lopressor).
• Diuretics — These medications cause frequent urination, keeping fluids from collecting in the body. Examples include bumetanide (Bumex), furosemide (Lasix) and hydrochlorothiazide.

Adopting a healthier lifestyle can help prevent heart failure. Important lifestyle factors include avoiding tobacco, maintaining a healthy weight, eating a heart-healthy diet, limiting alcohol and staying physically active.

Heart failure is a serious chronic disease. The rate of death five years after diagnosis is 50 percent in men and 46 percent in women.

Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today's health and medical news. To subscribe, please call 800-333-9037 (toll-free), extension 9771, or visit Mayo Clinic Health Letter Online.

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