Congestive Heart Failure: An Overview

Heart failure, often referred to as congestive heart failure, is a medical condition that affects the heart and circulatory system as it pertains to the heart. Heart failure refers to the heart’s diminished ability to pump and distribute blood throughout the body via the circulatory system and encapsulates a number of sub-conditions that are classified as congestive heart failure. Such conditions include narrowed arteries in the heart, which is known as coronary artery disease, as well as the condition of high blood pressure, which can stiffen or weaken the muscle of the heart so that it cannot fill itself with or pump blood effectively or efficiently (Mayo Clinic Staff 2013).

In a landmark study called the Framingham Study that is referenced repeatedly in the literature pertaining to congestive heart failure, more than 8,200 men and women were studied from 1971 to 1996 in order to measure the rate at which people might develop some form of congestive heart failure and to see what factors of lifestyle and heredity and pother criteria might influence such development of the disease (Lloyd-Jones et al., 2002). From this study, the researchers found that the “lifetime risk for [developing congestive heart failure] is 1 in 5 for both men and women. This is unusual, since diseases can often vary between genders; however, in this study, such differences were negligible (2002). Lloyd-Jones et al. conclude that congestive heart failure is both on the rise and a serious concern for public health, affecting millions of people and impacting the health care system in terms of resources for treating the disease, which can include medical equipment, pharmacological agents, and skilled personnel who have training with treating the disease (2002).

Hypertension is a related condition to forms of congestive heart failure, and in their important study from 1996 that incorporated data and research, Levy et al. found that hypertension, which was defined as 140 mm Hg systolic or 90 mm Hg diastolic or the current use of medication used to regulate blood pressure, men with hypertension had a 200 percent increase and women with hypertension had a 300 percent increase in risk for developing congestive heart failure disease in some form.

Some good and thorough understanding of the symptoms of congestive heart failure among adults as well as among children have been known for some time, and the causes for the disease have also been attributed to certain factors. Writing for the American Academy of Pediatrics, Keith observed factors that determined congestive heart failure among infants and children under broad categories including valvular obstruction or insufficiency, mechanical obstruction, physical effects of shunts, high blood pressure, inflammatory reaction within the heart, lack of oxygen, and metabolic disturbances (1956). This indicates that congestive heart failure, at least among young patients, can be onset through a number of physical and chemical means.

Treatment for congestive heart failure ranges from prescribing an increase in exercise and change in diet to lower blood pressure and high cholesterol, to the use of pharmacological solutions to control chemistry and reduce physical stress or impairment on the heart. Treatment ranges from treating symptoms to helping the heart function more effectively, healthily, and efficiently. Pharmacological solutions that affect blood pressure can be seen as treating symptoms, whereas those that help strengthen heart tissue or provide permanent elasticity to chamber walls or the valves could be viewed as conditioning the heart. Chatterly (2002) concludes, “Thus, therapy of heart failure should consist of pharmacologic agents not only to relieve symptoms but also to prevent and attenuate ventricular remodeling and progressive heart failure, thereby improving prognosis” (2).

One area of concern for medical practitioners working in the field today at clinics, hospitals, and elsewhere is the rise of diabetes among the general populace and the possible connection between congestive heart failure and diabetes. In their assessment and study that included incorporation of data and results from the Framingham Study, Kannel et al. discovered a 400 to 500 percent increase of the likelihood of the development of some form of congestive heart failure in patients who were part of the study who were also diagnosed with a form of diabetes (29). Thus, the link between congestive heart failure and diabetes is confirmed and, moreso, it raises concerns for medical professional practitioners who are facing a diabetes epidemic in the future years.

Congestive heart failure is a disease that is devastating and deadly, affecting roughly 20 percent of the American population. Given the increase of people with hypertension and especially the increase of diabetes, both men and women are an increased risk of developing congestive heart failure disease. With risk for developing the disease appearing in some cases as early as birth and infancy, it becomes important to have the latest understanding of the disease, its causes and connections to other diseases and conditions such as diabetes, and both the pharmacological and physical ways of treating and combatting the disease, such as increase in exercise and a proper diet as well as the continued development of drugs and medications that aid in the treatment of the symptoms and causes of congestive heart failure for people living in the world today.

References

American Heart Association. Congestive heart failure. Retrieved from http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Congestive-Heart-Failure_UCM_307111_Article.jsp.

Chaterjee, K. (2002). Congestive heart failure. American journal of cardiovascular drugs, 2(1). 1–6.

Levy, D., Larson, M., Vasan, R., Kannel, W., Ho, K. (1996). The progression from hypertension to congestive heart failure. Journal of the American Medical Association, 275(20), 1557–1562. doi: 10.1001/jama.1996.03530440037034.

Kannel, W., Hjortland, M., Castelli, W. (1974). Role of diabetes in congestive heart failure: The Framingham study. The American Journal of Cardiology, 34(1). 29–34.

Mayo Clinic Staff (August 2013). Heart failure. Retrieved from http://www.mayoclinic.com/health/heart-failure/DS00061.

Keith, J. (1956). Congestive heart failure. American academy of pediatrics. Retrieved from http://pediatrics.aappublications.org/content/18/3/491.short.

Lloyd-Jones, D., Larson, M., Leio, E., Beiser, A., D’Agostino, R., Kannel, W., Murabito, J., Vasan, R., Benjamin, E., Levy, D. (2002). Lifetime risk for developing congestive heart failure: The Framingham heart study. Circulation, 106:3068–3072. doi: 10.1161/01.CIR.0000039105.49749.6F

Yusef, S., Pitt, B. (2002) A lifetime of prevention: The case of heart failure. Circulation, 106:2997-2998. doi:10.1161/01.CIR.0000046804.13847.5D