Congestive Heart Failure Common But Underrecognized
Persons experiencing shortness of breath and fatigue should seek medical treatment immediately, according to a new report, which suggests these are not signs of aging but indicators of congestive heart failure.
Congestive heart failure, also known as heart failure, is not a disease but a condition that occurs when the heart is unable to pump enough blood to meet the needs of the body’s tissues. When the heart fails, it is unable to pump out all the blood that enters its chambers. The condition affects about 5 million Americans with another 16 to 20 million patients at risk of developing it.
“If you are short of breath and fatigued, you need to see your doctor to determine whether you have heart failure,” says Milton Packer, MD, director of the Center for Heart Failure Research and Chief of the Division of Circulatory Physiology at Columbia-Presbyterian Medical Center in New York City.
Packer, who is also a professor of medicine and pharmacology at Columbia University College of Physicians and Surgeons, says that the challenge facing both physicians and patients is timely recognition of the condition. Packer points out that only 15% of the heart failure patients are getting the drugs while 80% could benefit from them.
“There is an enormous educational process not just for physicians but for patients,” says Packer. “Patients need to take active control recognizing the symptoms of the condition, seeking medical advice and making sure they are part of the process of selecting the appropriate therapy.”
Currently, there are 4 classes of medications used to treat heart failure:
*Diuretics–drugs to reduce fluid,
*Vasodilators, particularly ACE inhibitors–drugs that dilate blood vessels,
*Inotropics, usually Digoxin–drugs that increase the heart’s ability to contract,
*Beta blockers–drugs that block activities of stress hormones on the failing heart.
Packer notes that these drugs are used complimentarily. “There is no single magic bullet that solves the problem of heart failure,” says Packer. Other treatments include surgical procedures and heart transplantation. There are experimental drugs in clinical trials, and Packer says he hopes those will bring new tools to the management of heart failure.
Ann Bolger, MD, a spokesperson for the American Heart Association, says, “Now more than ever before, we have some tremendously effective treatments for heart failure both in terms of symptomatic relief and in terms of survival.”
Bolger, who is also an associate clinical professor of medicine at the University of California at San Francisco, says that heart failure is becoming one of the most common cardiovascular conditions. It is a common end point to a lot of different types of heart disease, such as coronary artery disease, damage after a heart attack, high blood pressure and diabetes–all can lead to heart failure at different stages.
“Recognition and early diagnosis are very important,” says Bolger. “The challenge is not only to continue research in this area but also to make sure heart failure patients receive the full spectrum of treatments they need.”
Bolger also points out that all the things that are useful for coronary artery disease will decrease your long-term, down-the-road heart failure risk. “We need to do a lot better job at treating persons with high blood pressure. As is true of any other disease, the best approach to heart failure is to never get it.”
The report was presented this week at an American Medical Association media briefing on heart disease in New York City.
Article By: Hong Mautz, Medical Writer
Publication Date: May 2001
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