Heart failure is a growing problem. According to some estimates, over 5.1 million Americans have the condition, with around 650,000 new cases diagnosed each year. Other sources put that figure closer to 6.5 million, with approximately 960,000 new cases every year. At the same time, progress has been made and continues to be made in treatment methods for the disease.
Heart Failure Treatment
Heart failure treatment is based on the severity of the disease and any other medical conditions you may have. Your doctor typically advises you on which treatment plan may best fit your needs.
There is currently no cure for heart failure. The main goal of any treatment of heart failure is preventing the condition from worsening by managing any fluid buildup and lowering your blood pressure.
Heart Failure Medications
There are several medications that your doctor may prescribe based on the severity of your heart failure. The main ones are vasodilators, diuretics, and ACE inhibitors:
- Vasodilators. Vasodilators are a type of drug most commonly used to help manage high blood pressure. They relax the muscles in the walls of blood vessels, causing them to widen and create improved blood flow. In the heart, this helps the ventricles to pump more blood.
- Diuretics. When your heart is not pumping enough blood around the body, it can cause a fluid buildup. Suppose your doctor feels you may be at risk for fluid retention and congestion. In that case, they may prescribe diuretics or water pills to help your body get rid of the excess fluid. Not everyone agrees that diuretics are the best form of treatment. Some studies are concerned about the impact on the rest of the body, especially the kidneys, of a patient regularly taking diuretics. Therefore, it is important to have regular checkups so your doctor can monitor your kidney function and potassium levels.
- ACE Inhibitors. Angiotensin-Converting Enzyme (ACE) Inhibitors are used primarily in the management and treatment of hypertension. For heart failure patients, an ACE inhibitor lowers your blood pressure and reduces the heart’s workload. Lowering the heart’s workload helps it to regain some of its strength.
- Angiotensin Receptor Blockers (ARBs). These are medications that work on a similar mechanism of ACE inhibitors. While the former reduces the amount of angiotensin II, the ARBs block the angiotensin II effect at the receptor level and offer comparable outcome benefits as do the ACE inhibitors.
- Angiotensin Receptor Blockers/Neprolysin inhibitors (ARNI’s). There is only one in this class by the brand name of Entresto and it offers significant benefit for patients with congestive heart failure improving survival and reducing symptoms and hospitalizations for heart failure.
- Sodium Glucose Type-2 Inhibitors (SGLT2). These are medications that have been used for diabetics to control glucose but evidence is accumulating for them reducing CHF hospitalizations. Dapagliflozin (Farxiga) has now been approved to improve survival and hospitalizations for heart failure for patients with weaker hearts and CHF with or without diabetes.
Device Therapy
Suppose you are suffering from severe heart failure or heart irregularities. In that case, your doctor may need to use a device to treat you:
- Implantable cardioverter-defibrillator (ICD). An implantable cardioverter-defibrillator (ICD) is a surgically inserted device that delivers an electric countershock to the heart when it detects a life-threatening abnormal heart rhythm.
- Cardiac Resynchronization Therapy (CRT). Some patients’ heart failure causes an abnormality in the electrical activity and pulses that go through their hearts. This abnormality can change the efficiency of their heartbeats. When this occurs, cardiac resynchronization therapy (CRT) may be used. In CRT, a special pacemaker is inserted that resynchronizes the ventricles in the heart and helps them contract more normally.
- Left ventricular assist device (LVAD). The left ventricle of your heart is the one that pumps blood out to the rest of the body. When you have heart failure, this ventricle becomes weakened and has difficulty pumping blood. A left ventricular assist device (LVAD) acts as an artificial heart pump, helping the left ventricle pump blood. It is typically used for patients with advanced heart failure and those waiting for a heart transplant.
- BaroStim Neo. This is a type of device that has been approved by the FDA recently to improve symptoms of CHF and reduce hospitalizations for heart failure. The mechanism is essentially reducing sympathetic nervous activity over time.
Patient Education and Management of Heart Failure
As well as medications and devices, educating people about heart failure is a crucial tool in helping prevent and manage the condition:
- Healthy Lifestyle Changes. According to the Centers for Disease Control (CDC), certain behaviors increase your risk of heart failure. Among the risk factors are smoking; eating foods that are high in fat, cholesterol, and sodium; drinking too much alcohol or caffeine; and not getting enough physical activity. Adding healthy foods to your diet such as fresh fruit and vegetables, whole grains, and low-fat dairy products can help reduce your risk of heart failure or manage your condition. Exercising regularly and maintaining a healthy weight also helps.
- Sudden Weight Change and Fluid Retention. A common symptom of developing heart failure is sudden weight loss or gain. The American Heart Association advises that if you gain or lose three or more pounds in a day or five or more pounds in a week, you should see a doctor. Similarly, if you find that you’re not urinating regularly, you might be retaining fluids. Water retention is another one of the signs of heart failure, and you should get it checked by a doctor.
Regularly monitoring your blood pressure and ensuring you get a sufficient amount of rest and sleep can help lower your risk of heart failure or manage your condition.
Surgical Intervention
Surgery isn’t a typical method for treating people with heart failure and is only used when your doctor identifies a correctable problem. Surgical interventions usually involve either a heart transplant, bypass surgery, heart valve surgery, or angioplasty, all of which are used to treat specific blockages in the heart.
The goal of any treatment for heart failure is to slow down the progression of the disease, ensuring patients don’t get sicker. If left untreated, some people may die within five years after being diagnosed.
If your doctor has told you that you have congestive heart failure, there’s no reason not to start taking action right away.
References
- Congestive Heart Failure
- Types of Blood Pressure Medications
- Heart failure – fluids and diuretics
- The use of diuretics in heart failure with congestion – a position statement from the Heart Failure Association of the European Society of Cardiology
- Angiotensin Converting Enzyme Inhibitors (ACEI)
- Learn About Heart Failure
- Devices and Surgical Procedures to Treat Heart Failure
- Focus on: Left ventricular assist devices
- Heart Failure
- Lifestyle Changes for Heart Failure