Treatment Advances Improve the Odds for Heart Failure
THURSDAY, Feb. 16 (HealthDay News) -- Although a growing number
of Americans now struggle with heart failure, experts say new
treatments have dramatically improved both quality of life and life
expectancy for these patients.
"The present environment for heart failure is substantially improved, and the future holds promises that will truly remove the term 'failure' from the description of this illness," said Dr. Gregg Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center in Los Angeles and co-director of the Preventive Cardiology Program at UCLA's David Geffen School of Medicine.
Dr. Clyde Yancy, past president of the American Heart
Association and chief of cardiology at Northwestern Memorial
Hospital in Chicago, seconded that notion, pointing to what he sees
as "the edge of a new dawn" in which advances in treatment will
enable clinicians to "take the heft, the drama and the 'failure'
out of heart failure."
To raise public awareness, the American Heart Association has
deemed this week National Heart Failure Awareness Week.
A little understood medical condition, the symptoms of heart
failure include extreme fatigue, weakness and/or shortness of
breath, as years of poor nutrition, inactivity, high blood
pressure, high cholesterol, excessive weight and related health
complications, such as diabetes, take a cumulative toll on an
In turn, the heart muscle strains, and ultimately fails, to
carry out its continuous duty of pumping blood (and the oxygen it
carries) throughout the body. This makes everyday acts such as
walking or climbing stairs a major effort for patients. Heart
failure is now estimated to affect 6 million men and women in the
"Anybody in the population over the age of 40 has a 20 percent chance of developing heart failure, regardless of your medical history," Yancy said. "Which means, in short, that all of us are at risk. And of course those with a history of heart disease have an even higher risk."
However, Yancy noted, "just a few years ago we had nothing we
could say that was particularly encouraging. It wasn't a disease
for which there was much hope or optimism. But that has totally
turned around now."
Fonarow credits the shift to a decade of drug and medical device
innovation. On the one hand, there is the advent of whole new
classes of medications -- such as ACE inhibitors, beta blockers and
aldosterone antagonists -- that help lower the risk for developing
heart failure, while expanding treatment options when it does
And, Yancy added, "We also know that cardiac rehabilitation --
namely an exercise regimen -- can also help. Years ago, we told
patients to just take it easy. But, now we know that an active
vigorous lifestyle is actually a better way to go."
At the same time, Fonarow pointed to the rise of small,
affordable and effective implantable electrical devices that have
helped physicians better control the sort of electrical
disturbances of the heart that can harm normal function.
"Even for the patient with far advanced disease, the utility of mechanical support -- artificial heart pumping devices -- has become remarkable," Fonarow noted. "We can sustain patients for a time sufficiently long enough to not only allow for heart transplantation, but also to serve as definitive therapy and, even more provocatively, to support recovery of heart muscle function."
The result: over the past decade heart failure hospitalizations
have actually declined, while the risk of death has plummeted 65
percent to 80 percent, Fonarow said. "What was once a dismal and
depressing diagnosis, with an over 50 percent five-year mortality
rate, is now a clinical scenario for which optimism and new hope
The future of heart failure treatment looks even brighter, said
Yancy, given developments now under way that revolve around
protein, gene and stem cell transplantation therapies designed to
help patients recover more fully after a heart attack.
"It is a reality that will take some more time to be fully realized," Yancy noted. "But it is assuredly coming down the road."
That said, he admits that the status quo is not entirely rosy,
given that U.S. hospitals now see roughly 500,000 new heart failure
patients come through their doors each year.
The key to lowering that number: helping the public connect the
dots between an unhealthy lifestyle and harm to the heart.
"For many people, heart failure is a fuzzy disease," Yancy noted. "People commonly think about their risk for a dramatic event, like a heart attack. But heart failure needs to be on everyone's consciousness because it develops quietly over time, as the heart gets weighed down by burdens such as obesity, diabetes and smoking," he explained.
"So, it's important to galvanize the public so that everyone knows that heart failure can be treated, but also prevented," Yancy said. "Because even though we can't cure it, we do know how to handle it. So, we can't approach it as if it's an inevitability. Because it's not."
For more on a heart-healthy lifestyle, visit the
American Heart Association.
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