Heart Failure, Blood Thinners and Cholesterol

Awareness

In a recently concluded conference organized by Prof. U Kaul (Founder Director, Gauri Kaul Foundation) on heart health, there were three key sessions: heart failure, blood thinning medicines and cholesterol-lowering medicines. Although the conference focused on recent advances in medicine for doctors, I found some important takeaways that our general population, especially seniors, should know.

Heart Failure

Heart failure is a chronic condition where the heart is unable to pump blood efficiently to meet the body’s needs. Recognizing the common symptoms and understanding the primary treatment strategies is crucial, especially for seniors, as early detection and proper management can significantly improve quality of life.

Common Symptoms of Heart Failure

1. Shortness of Breath:

Occurs during exertion or even at rest.

May be more pronounced when lying down, often causing the need to sleep with elevated pillows or in a sitting position.

2. Fatigue and Weakness:

Persistent tiredness that interferes with daily activities.

General feeling of weakness and lack of energy.

3. Swelling (Edema):

Swelling in the feet, ankles, legs, or abdomen due to fluid retention.

Rapid weight gain from fluid buildup.

4. Persistent Cough or Wheezing:

May produce white or pink-tinged mucus.

Coughing can be worse at night or when lying down.

5. Increased Heart Rate:

Sensation of a rapid or irregular heartbeat, often experienced as palpitations.

6. Confusion and Impaired Thinking:

Reduced blood flow can affect cognitive functions, leading to confusion or memory problems, particularly in older adults.

Heart Failure Treatment

The management of heart failure typically revolves around four modalities. These strategies are designed to alleviate symptoms, improve heart function, and enhance overall patient outcomes.

1. Medications:

ACE Inhibitors/ARBs: These drugs help relax blood vessels, lower blood pressure, and reduce the heart’s workload.

Beta-Blockers: These help slow the heart rate and reduce blood pressure, leading to decreased heart workload and improved heart function.

Diuretics: Often referred to as “water pills,” these medications help reduce fluid buildup in the body, alleviating swelling and shortness of breath.

Aldosterone Antagonists: These help manage blood pressure and fluid levels by blocking the hormone aldosterone.

SGLT2 Inhibitors: This antidiabetic medicine has proven beneficial in treating heart failures.

Vericiguat: This new medicine has shown promising results in preventing readmission due to heart failure.

2. Lifestyle Modifications:

Diet: Low-sodium diet to help manage fluid retention; balanced meals to support heart health.

Exercise: Regular, moderate physical activity tailored to individual capability helps strengthen the heart and improve overall fitness.

Weight Management: Maintaining a healthy weight reduces strain on the heart.

Smoking Cessation and Avoiding Alcohol : Avoiding tobacco and alcohol intake are crucial for heart health.

3. Device Therapy:

Implantable Cardioverter Defibrillators (ICDs): These devices help prevent sudden cardiac arrest by monitoring and correcting abnormal heart rhythms.

Cardiac Resynchronization Therapy (CRT): A specialized pacemaker that helps both sides of the heart contract more synchronously, improving heart function.

4. Surgical and Advanced Interventions:

Coronary Artery Bypass Grafting (CABG): This surgery improves blood flow to the heart by redirecting blood around clogged arteries.

Heart Valve Repair or Replacement: Corrects valve dysfunctions that can contribute to heart failure.

Left Ventricular Assist Devices (LVADs): Mechanical pumps that assist the heart in pumping blood more effectively, often used in advanced heart failure cases.

Heart Transplant: Considered in end-stage heart failure when other treatments have not been effective.

The other session focused on blood thinners for stroke and heart attack patients. It is crucial for patients to adhere to their doctor’s advice, even if they feel better. They should not stop or lower the dose of blood thinners on their own; only their doctor should decide when to discontinue the medication.

Regarding cholesterol-lowering medicines like statins: please follow the prescriptions carefully. There are many false claims and controversies surrounding the use of statins, but these claims lack evidence-based backing. Maintaining low levels of bad cholesterol (LDL) is always beneficial for overall health, particularly for cardiovascular health. Statins have proven to be effective in achieving and maintaining this health.