A Failing Heart: Interventions and Preventions
Heart failure occurs when the heart can no longer pump out enough blood to supply what the body needs. The result is fatigue, shortness of breath, and fluid retention—all classic signs of heart failure. Many people don’t realize that heart failure is not actually a disease, rather it’s the result of injury to, or a weakness of, the heart.
While age is a risk factor, the majority of heart failure patients are over age 65 and have preexisting high blood pressure, which is a manageable, and often preventable condition. Nearly 50 percent of heart failure patients have coronary artery disease and have had a heart attack. Other causes of heart failure include cardiomyopathy (a disease of the heart muscle), heart valve disease, and congenital heart disease (a heart defect from birth). Unfortunately, once heart failure begins, normal heart function may never return.
WHAT YOU SHOULD KNOW
The American Heart Association lists the following as some of the known and suspected risk factors for heart failure:
- Age, male sex
- Hypertension (high blood pressure)
- Left ventricular hypertrophy (thickening of the left ventricle wall)
- Myocardial infarction (heart attack)
- Diabetes mellitus
- Obesity
- Smoking
- Dyslipidemia (a disorder of blood cholesterol or fats)
- Sleep-disordered breathing
- Sedentary lifestyle
- Psychological stress
- Alcohol abuse
Heart failure is among the most frequent causes of hospitalization for Americans over age 65. And more patients are hospitalized for heart failure complications than all cancers combined. However, there is a way that heart failure patients can improve the quality of their daily lives, and also reduce the need for going to the hospital.
“Often after a recent heart event or new heart failure diagnosis, the patient is unsure of when and how to resume physical activity and general activities of daily living,” explains exercise physiologist Lauren Harning with the UCLA Cardiopulmonary Rehab Center. “Cardiac rehab is a medically supervised program that includes exercise training, education on heart-healthy living and lifestyle, and counseling to reduce stress. The program helps patients learn how to self-manage their blood pressure, body weight, sodium intake and stress, all of which helps to reduce hospitalizations, and even some medications.”
According to Harning, patients often report a higher level of energy, stability in blood pressure and body weight, reduced shortness of breath, and better sleep after just a few weeks in a cardiac rehab program.
Exercise May Extend Life in Heart Failure Patients
According to research presented at Heart Failure 2016 and the 3rd World Congress on Acute Heart Failure, researchers from the UK reported that heart failure patients who exercised lived longer compared to those who did not—regardless of heart failure severity, age, or gender.
The researchers analyzed exiting data from more than 4,000 heart failure patients. Exercise was associated with an 18 percent lower risk of all-cause mortality and an 11 percent reduced risk of hospitalization, compared with no exercise.
According to the researchers, exercise may benefit patients with heart disease, including heart failure, in a number of ways. Exercise improves the oxygen supply to the heart, and reduces the likelihood of the abnormal rhythms that can cause sudden death. Physical activity also improves circulation in the peripheral vasculature, such as in the leg muscles, which may reduce the workload of the heart and improve patients’ ability to function.
Principal investigator Professor Rod Taylor, chair of health services research and director of the Exeter Clinical Trials Unit at the University of Exeter Medical School in Exeter, UK says, “If heart failure patients are active we can be pretty sure that they will live longer. The simple advice would not be to take up marathon running. This is about increasing one’s routine physical activity, for example walking for 20 to 30 minutes three times a week at an intensity that makes you feel a little bit breathless but not necessarily symptomatic.”
Heart Failure Is Preventable
Because heart failure usually results from another disease, it may be preventable when the underlying risk factors are avoided and/or properly managed. This is especially important for African-American men who are more likely to have heart failure than women or Caucasians. Knowing the risk factors can help you avoid heart failure.
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