Download The Prevention of Heart Failure

The Prevention of Heart Failure
Almost five million people in the United States have heart failure. It is estimated that
approximately four times that many may have abnormalities in their heart function but do not
have symptoms of heart failure. Since it is expected that these patients will progress to
symptomatic heart failure and the death rate in the presence of symptoms is 50% in five years,
prevention of heart failure should be a primary goal. Many studies have shown that treatment
will prevent or limit the progression of heart failure.
Certain risk factors may indicate that the patient has undiagnosed abnormal heart function or is at
higher risk for heart muscle dysfunction. These factors are:
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High blood pressure (more than 135/85).
Diabetes mellitus (blood sugar greater than 120 or HgbA1c greater than 7%)
Over 70 years of age
History of coronary artery disease (hardening of the arteries)
Atrial fibrillation (rhythm disturbance)
EKG abnormalities
If one or more of these risk factors are present, the patient should be evaluated for heart failure.
We would suggest a lab test call BNP. If this is normal, for the age group, there is a very low
likelihood that there are any abnormalities in heart function. If the test is not normal, the patient
may require an echocardiogram (ultrasound) test of the heart. There are other factors that may
be associated with heart failure but are not felt to be in this risk factor equation including:
abnormal cholesterol levels, lack of activity, obesity, family history, excessive alcohol intake
and/or certain medications (cancer drugs).
If the echocardiogram is abnormal, each patient should be placed on medications called beta
blockers and ACE inhibitors. Both of these drugs have been shown to reduce or prevent the
progression of heart failure. In addition, or if the echocardiogram is normal, all of the other risk
factors that contribute to heart failure should be treated.
CLASSIFICATIONS OF HEART FAILURE
A. Patients with conditions at high risk for future development of heart failure, but without
structural heart abnormalities (50-60 million in the U.S)
B. Patients with structural heart disorder strongly associated with the development of heart
failure, who have never presented symptoms or signs of heart failure (8-10 million).
C. Patients with current or prior symptoms of heart failure associated with structural heart
disease (5 million).
D. Patients with end stage heart failure, i.e. severe symptoms despite maximal medical
therapy, who require specialized treatment (50-200 thousand).