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Heart Failure

Heart Failure

  • Heart failure refers to a large number of conditions which affect the structure or function of the heart, making it harder and harder for the heart to supply sufficient blood flow to meet the body’s needs. Heart failure does not mean that your heart has stopped working.1
  • Heart failure occurs when the heart loses its ability to maintain proper blood flow. This can happen because the heart cannot relax and fill well enough with blood (diastolic heart failure) or because the heart cannot contract strongly enough (systolic heart failure) to propel the blood with enough force to maintain proper circulation. In some people, both types of heart failure can occur.1
  • Heart failure is a major and growing public health problem in the U.S affecting 5.7 million people it is the primary reason for 12 to 15 million office visits and 6.5 million hospital days each year. Heart failure is the most common hospital discharge diagnosis for senior citizens affecting 1% of people over the age of 65 in the US. More Medicare (health insurance for the elderly) dollars are spent for the diagnosis and treatment of heart failure than for any other diagnosis. 
  • At 40 years of age, the lifetime risk of developing heart failure for both men and women is 1 in 5. The number of people experiencing heart failure has increased steadily during the last two decades─ thanks to better treatment and improved survival rates.
  • The four major contributors to heart failure are coronary artery disease (CAD), high blood pressure, diabetes, and dilated cardiomyopathy. Heart failure can also result from heart defects, arrhythmias, unhealthy lifestyles, and more. High blood pressure is the most common cause of heart failure with 75% of patients having high blood pressure before they develop heart failure.
  • The most common signs of heart failure are shortness of breath, fatigue, and swelling in the feet, ankles, legs, and abdomen.
  • Medication can help stem progression of heart failure and most patients take a combination of a diuretic (water pill), ACE inhibitor, and beta-blocker. Lifestyle changes are critical to slowing heart failure.
  • Some patients may need cardiac resynchronization therapy, defibrillators, pacemakers, or heart assist devices. Some of these devices can cost as high as $500,000 and explains the exorbitant cost of medical care in the US (17% of the GDP).
  • Patients with end-stage heart failure require heart transplantation to survive.1 
  • The prevalence, prognosis, and outcomes of heart failure in the Asian Indian population are not well documented. Limited studies have shown that Asian Indians and other South Asians suffer from a higher risk of heart failure. This is thought to be related to the increased prevalence of premature CAD and diabetes in this population.2-4

Sources

1. CardioSmart. American College of Cardiology.

2. Singh N, Gupta M. Clinical characteristics of South Asian patients hospitalized with heart failure. Ethn Dis. Autumn 2005;15(4):615-619.

3. Blackledge HM, Newton J, Squire IB. Prognosis for South Asian and white patients newly admitted to hospital with heart failure in the United Kingdom: historical cohort study. Bmj. Sep 6 2003;327(7414):526-531.

4. Newton JD, Blackledge HM, Squire IB. Ethnicity and variation in prognosis for patients newly hospitalised for heart failure: a matched historical cohort study. Heart. Dec 2005;91(12):1545-1550.

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