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Canadian Med Center

Heart Failure and Cardiovascular Death: Treatment and Prevention

Tuesday 19 March 2024
Cardiovascular Disorders
6 minute(s) read
By Kiran Altaf

Table of Contents

I. What is Heart Failure?

II. Treating Heart Failure

III. Preventing Heart Failure

IV. Conclusion

Heart failure affects over 5 million people in the United States and is the most common diagnosis among hospitalized patients over 65 years old. While there is no cure, treatment can help manage symptoms and prolong life for many years. [1]

In this article, we’ll discuss what heart failure is and how it can be treated and prevented.

What is Heart Failure?

Heart failure occurs when the heart cannot pump enough blood to meet the body's needs. This happens when the heart muscle is weakened or stiffened, impairing its pumping ability. When the body does not receive sufficient blood flow, it also does not get enough oxygen and nutrients, which can become life-threatening. [2]

The main types of heart failure are left-sided and right-sided, named according to which side of the heart is affected.

  • Left-sided heart failure is the most common form involving the left ventricle on the bottom left side of the heart. When the left ventricle cannot pump out enough blood, fluid backs up into the blood vessels carrying blood from the lungs. Left-sided heart failure is further classified as either heart failure with reduced or preserved ejection fraction. In heart failure with preserved ejection fraction (diastolic heart failure), the left ventricle has difficulty relaxing between beats, limiting its ability to fill with blood. In heart failure with reduced ejection fraction (or systolic heart failure), the left ventricle cannot contract normally, pumping out less blood.
  • Right-sided heart failure affects the right ventricle on the bottom right side of the heart. When the right ventricle pumps inefficiently, blood backs up into vessels carrying blood back to the heart from the rest of the body. This buildup can force fluid from the veins into surrounding tissues, often causing swelling.
  • Biventricular heart failure involves both sides of the heart, with symptoms of both left-sided and right-sided heart failure. [2]

Heart failure may also be categorized as:

  • Acute: Active heart failure symptoms, either newly diagnosed or long-term heart failure.
  • Chronic: History of heart failure but relatively stable condition with minimal or manageable symptoms. [2]

Heart failure is typically caused by an underlying condition. The three most common causes are:

  • Coronary artery disease: Narrowing of the arteries supplying the heart, forcing it to work harder and eventually weakening the muscle.
  • Heart attack: Scar tissue from a heart attack interferes with the heart's pumping ability.
  • High blood pressure: Increased pressure on artery walls can lead to heart failure over time. [2]

Treating Heart Failure

a doctor listening to a patient

While heart failure may not have a cure, various treatment options are available to help you live a longer, more active life with fewer symptoms. The specific treatment approach depends on the type and severity of heart failure. [3]

Medications for Left-Sided Heart Failure

Several medication options help treat left-sided heart failure with reduced ejection fraction. These aim to remove excess fluid, relax blood vessels, slow heart rate, and strengthen the heartbeat.

  • Diuretics and aldosterone antagonists are often prescribed to remove excess sodium and fluid, reducing the workload on the heart. While effective, higher doses of diuretics can cause low blood pressure, kidney disease, and worsening symptoms. Aldosterone antagonists may lead to high potassium levels and kidney problems. [3]
  • Vasodilators, such as ACE inhibitors and angiotensin receptor blockers (ARBs), relax blood vessels, making it easier for the heart to pump blood. Possible side effects include cough, low blood pressure, and temporary kidney impairment. [3]
  • Beta-blockers slow the heart rate, allowing the heart to pump blood easily and preventing long-term decline. However, they can also cause a slow heart rate, high blood pressure, and vision issues like blurriness or halos. [3]
  • SGLT2 inhibitors, like Jardiance (empagliflozin), were recently FDA-approved to reduce the risk of cardiovascular death and hospitalization in adults with heart failure. [4]
  • Digoxin may be prescribed when other medications fail to improve symptoms. This medication strengthens the heart's contractions, leading to increased blood pumping. However, it is typically reserved for serious cases of heart failure due to potential side effects such as digestive problems, confusion, and vision issues. [3]

For left-sided heart failure with preserved ejection fraction, diuretics are currently the main treatment option. Your doctor may also prescribe blood pressure medications to help relieve your symptoms. [3]

Medications for Right-Sided Heart Failure

If you are diagnosed with right-sided heart failure, your doctor will likely prescribe medications to help manage your symptoms and slow the progression of the disease. The main types of medicines used for right-sided heart failure are diuretics, aldosterone antagonists, ACE inhibitors, and ARBs. [3]

  • Diuretics, also known as "water pills," help remove excess sodium and fluid from your body. This decreases the amount of blood the heart needs to pump. Examples of diuretics include furosemide and bumetanide. High doses can sometimes lead to low blood pressure, kidney disease, or worsening heart failure.
  • Aldosterone antagonists help eliminate excess fluid. They block a hormone called aldosterone that causes salt and water retention. Side effects may include high potassium levels or kidney dysfunction.
  • ACE inhibitors and ARBs relax blood vessels, making it easier for the heart to pump blood. ACE inhibitors prevent the formation of angiotensin II, a hormone that narrows blood vessels. ARBs block the effects of angiotensin II. Possible side effects include cough, low blood pressure, or a temporary decrease in kidney function. [3]

Preventing Heart Failure

healthy food in the shape of a heart

Several studies have reported reduced risk for heart failure with a healthy lifestyle. Maintaining a healthy weight, avoiding smoking, engaging in exercise, and a healthy diet have been shown to reduce heart failure risk factors, including coronary disease, diabetes, and hypertension. [5]

To help keep your heart healthy and lower your chances of heart failure down the road, focus on the following:

  • Manage your weight. Carrying excess pounds, especially around your middle, strains your heart and can change its structure and function over time. Being overweight also contributes to conditions like high blood pressure, diabetes, and inflammation—all of which tax the heart. Aim for a body mass index (BMI) in the normal range.
  • Stay active. Leading a sedentary lifestyle is a major risk factor for heart failure. Regular physical activity has been proven to reduce the risk of cardiovascular disease, high blood pressure, and diabetes. The American Heart Association recommends a minimum of 150 minutes of aerobic activity per week and two days of resistance training to maintain optimal heart health.
  • Don't smoke. Smoking damages the heart muscle and contributes to the stiffening of the heart's left ventricle. Even smoking one to four cigarettes a day doubles the risk of heart attack. If you smoke, commit to quitting.
  • Follow a healthy diet. A balanced diet low in sodium, like the DASH diet, can help prevent high blood pressure and coronary artery disease, two conditions that often lead to heart failure. Focus on fruits and vegetables, whole grains, lean proteins like fish and chicken, nuts, and low-fat dairy. Limit red meat, sweets, and sugary beverages. [5]

Conclusion

Heart failure is a chronic and potentially life-threatening condition that requires comprehensive management to improve symptoms and long-term outcomes.

Understanding the risk factors, recognizing the symptoms, and adopting preventive strategies can reduce your risk of heart failure and cardiovascular death. Early diagnosis and appropriate treatment are crucial in effectively managing heart failure.

To learn more about this condition, visit our cardiovascular disorders blog.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.

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