Classes Of Medications For Heart Failure
Doctors use a variety of medicines to manage heart failure. This includes drugs that reduce the hearts workload, help the heart pump more blood, and reduce fluid buildup in the body. Your doctor may also recommend drugs to prevent blood clots and reduce cholesterol. Most people with heart failure take more than one medication.
Classes of heart failure drugs include:
To help doctors choose the best treatment, they follow expert guidelines and recommendations. Your doctor will consider your symptoms, test results, and stage of heart failure. After starting treatment, your doctor will monitor your response. It may be necessary to adjust your dose, change drugs, or add another drug for optimal treatment.
Water Pills Or Diuretics
Diuretics help your body get rid of extra fluid. Some types of diuretics may also help in other ways. These drugs are often called “water pills.” There are many brands of diuretics. Some are taken once a day. Others are taken 2 times a day. The most common types are:
- Thiazides. Chlorothiazide , chlorthalidone , indapamide , hydrochlorothiazide , and metolazone
- Loop diuretics. Bumetanide , furosemide , and torasemide
- Potassium-sparing agents. Amiloride , spironolactone , and triamterene
When you take these medicines, you will need regular blood tests to check how well your kidneys are working and measure your potassium levels.
What Are The Symptoms Of Heart Failure
You may not have any symptoms of heart failure, or the symptoms may be mild to severe. Symptoms can be constant or can come and go. The symptoms can include:
- Congested lungs. Fluid backup in the lungs can cause shortness of breath with exercise or difficulty breathing at rest or when lying flat in bed. Lung congestion can also cause a dry, hacking cough or wheezing.
- Fluid and water retention. Less blood to your kidneys causes fluid and water retention, resulting in swollen ankles, legs, abdomen , and weight gain. Symptoms may cause an increased need to urinate during the night. Bloating in your stomach may cause a loss of appetite or nausea.
- Dizziness, fatigue, and weakness. Less blood to your major organs and muscles makes you feel tired and weak. Less blood to the brain can cause dizziness or confusion.
- Rapid or irregular heartbeats. The heart beats faster to pump enough blood to the body. This can cause a rapid or irregular heartbeat.
If you have heart failure, you may have one or all of these symptoms or you may have none of them. They may or may not indicate a weakened heart.
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The Dangers Of Cardiovascular Damage Due To Drug Use
Asking can drug abuse cause congestive heart failure? is an important question with addiction rates on the rise nationally.1 Unfortunately, people using drugs regularly often mix these substances with alcohol to enhance the physical and psychological high.
The American College of Cardiology Journal has found that mixing drugs and alcohol increases the risk of a heart attack, irregular heart rate, and congestive heart failure.2 Its very common for those using drugs to experience a hike in blood pressure.
When a persons heart has to work harder to move blood throughout the body, it doesnt take long for issues with other organs to follow. Mixing drugs and alcohol only enhances the potential for damage to the heart.
Regular drug use can also cause damage to the tissues surrounding the heart and the vital blood vessels that transport blood throughout the body. When these blood vessels cant perform their job correctly, theres a risk that waste products can travel to the liver or kidney.
What Foods Should Be Avoided With Congestive Heart Failure
Dietary changes are a major part of heart failure treatment, and they will require certain foods to be reduced or eliminated in the diet:
- Salt: Above all else, avoid salty foods. Sodium contributes to the swelling and fluid retention that damages the heart, lungs, and other organs in patients with heart failure.
- Alcohol: Alcohol damages the heart muscle and will worsen heart failure.
- Fats: Saturated fats and trans-unsaturated fatty acids are associated with coronary heart disease, so your cardiologist or nutritionist will reduce your intake of saturated and trans fats.
- Carbohydrate snacks: Crackers, chips, cookies, popcorn all put on the pounds without adding much nutrition to the diet. Life expectancy is significantly reduced in heart failure patients who carry excess weight.
- Water: Fluid retention is common to heart failure and damages the heart and other organs, so only drink as much water and other liquids as advised by your cardiologist or nutritionist.
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What Are Some Congestive Heart Failure Treatment Options
Your treatment plan for congestive heart failure can consist of lifestyle changes, medications, and in advanced cases surgery.
Medications. This is the primary congestive heart failure treatment and can include:
Surgery and other procedures. If you dont respond to medications or the medications arent effective, surgery or other procedures may be required to manage your CHF. These procedures include:
How Is Congestive Heart Failure Treated
Doctors will assess the current health status of the patient to establish a baseline, and develop a long-term health plan with the goal of improving the patients health. This may involve the optimization of medicines and therapies, adding new medication, or possibly enrollment in a clinical trial.
Stabilizing and/or reversing a patients condition often involves long-term, collaborative follow-up with a referring cardiologist or physician.
In serious situations, advanced therapies, which include mechanical solutions, a heart transplant, or hospice, may be offered.
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Doses Used In Clinical Practice
In dedicated HF disease management programs and studies utilizing standardized protocol for medication dosing, it has been suggested a majority of patients can achieve target dosing. Without systematic approaches to care for these challenging patients it may be more difficult to reach target doses GDMT for many reasons. Yet, such effort is worthwhile in the Coreg Heart Failure Registry study, despite enrolling older patients with substantial comorbidities, most patients were able to achieve target doses of beta-blockers with a focused effort.
How Common Is Chf
Its estimated that about 6.5 million Americans have heart failure. That number is expected to rise dramatically in the next decade as the population gets older. The lifetime risk of getting heart failure is 20% for all Americans older than 40 years of age. Over 650,000 new cases of heart failure are diagnosed each year.
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What Is The Importance Of Ejection Fraction
Your ejection fraction is one way to measure the severity of your condition. If its below normal, it can mean that you have heart failure. Your ejection fraction tells your healthcare provider how good of a job your left or right ventricle is doing at pumping blood. Usually, your EF number is talking about how much blood your left ventricle is pumping out because its your heart’s main pumping chamber.
Several non-invasive tests can measure your EF. With this information, your healthcare provider can decide how to treat you or find out if a treatment is working as it should.
A normal left ventricular ejection fraction is 53% to 70%. An LVEF of 65%, for example, means that 65% of the total amount of blood in your left ventricle is pumped out with each heartbeat. Your EF can go up and down, based on your heart condition and how well your treatment works.
Biomarker Guided Medication Titration
The natriuretic peptides, B-type natriuretic peptide and N-terminal proB-type natriuretic peptide , have demonstrated both diagnostic and prognostic value in patients with HF. A decrease in natriuretic peptide levels over a period of follow-up has been associated with improved outcomes, including morbidity and mortality. Importantly, HF therapy guided by natriuretic peptides has not been shown to improve outcomes in HF patients Beta-blockers have been shown to substantially decrease natriuretic peptide levels in the long run, as have ACEi/ARBs and MRAs. One recent study demonstrated improved outcomes with patients who attained a significant reduction in NT-proBNP < 1000 importantly, treatment with sacubitril/valsartan was nearly twice as likely as enalapril to achieve reductions in NT-proBNP to this level. More data are needed regarding doses of medications and their interaction with natriuretic peptides, or other biomarkers, and clinical outcomes and importantly if doses should be specifically titrated to achieve specific biomarker levels rather than the current recommendation for maximally tolerated dosing.
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What Foods Should I Avoid If I Have Chf
If you have been diagnosed with CHF, making some simple adjustments to your diet can improve your quality of life. You will also need to reduce or eliminate certain foods and drinks from your diet that can increase fluid retention, increase your blood sugar, or lead to obesity. Foods/drinks to reduce or avoid include:
- Alcohol
How Can I Improve My Quality Of Life With Heart Failure
There are several things you can do to improve your quality of life if you have heart failure. Among them:
- Eat a healthy diet. Limit your consumption of sodium to less than 1,500 milligrams each day. Eat foods high in fiber. Limit foods high in trans fat, cholesterol, and sugar. Reduce total daily intake of calories to lose weight if necessary.
- Exercise regularly. A regular cardiovascular exercise program, prescribed by your doctor, will help improve your strength and make you feel better. It may also decrease heart failure progression.
- Don’t overdo it. Plan your activities and include rest periods during the day. Certain activities, such as pushing or pulling heavy objects and shoveling may worsen heart failure and its symptoms.
- Prevent respiratory infections. Ask your doctor about flu and pneumonia vaccines.
- Take your medications as prescribed. Do not stop taking them without first contacting your doctor.
- Get emotional or psychological support if needed. Heart failure can be difficult for your whole family. If you have questions, ask your doctor or nurse. If you need emotional support, social workers, psychologists, clergy, and heart failure support groups are a phone call away. Ask your doctor or nurse to point you in the right direction.
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Ace Inhibitors And Arbs
ACE inhibitors and ARBs work by opening blood vessels and lowering blood pressure. These medicines can:
- Reduce the work your heart has to do
- Help your heart muscle pump better
- Keep your heart failure from getting worse
Common side effects of these drugs include:
- Dry cough
- Headache
- Diarrhea
When you take these medicines, you will need to have blood tests to check how well your kidneys are working and to measure your potassium levels.
Most of the time, your provider will prescribe either an ACE inhibitor or an ARB.
Symptoms Of Heart Failure
Symptoms of heart failure include:
- new or worsening shortness of breath
- difficulty lying flat at night
- fainting or passing out
- weight gain
- muscular fatigue, tiredness
- swelling of ankles or legs
- swelling of abdomen
- heart palpitations
- chest pain or discomfort in parts of the upper body
- unexplained coughing and wheezing
- constipation.
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Can Drug Abuse Cause Congestive Heart Failure
As well explore, there is growing evidence showing that drug abuse can cause congestive heart failure. Even in recovery, many people still must deal with the complications of drug use and heart failure.
Heart failure is estimated to affect just under 6 million people each year in the United States. Its a serious and prevalent condition that indicates a persons heart is functioning less efficiently than it should.
There are many potential causes behind the development of congestive heart failure, such as high blood pressure and long-standing alcohol use disorder. Each damages the heart muscle over time. Subsequently, blood begins to move through the body and heart slower while blood pressure increases simultaneously.
Congestive heart failure is the hearts inability to pump enough nutrients and oxygens to meet the bodys basic and vital needs. Congestive heart failure may cause heart chambers to stretch or even thicken. The kidneys may begin to retain fluid in response to heart failure.
As fluids build, salt also accumulates in the body. Fluids and salts tend to congregate throughout the limbs, organs, and lungs. The result is congestion, known as congestive heart failure.
Congestive Heart Failure Medications
Medications are in most cases the primary treatment for heart failure. Medications are used in combination to manage the effects of heart failure such as fluid retention, swelling, vasoconstriction, and increased heart rate. In more advanced cases, medications are used to maintain a normal heart rhythm or to keep heart failure patients alive before surgery or heart transplant.
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Related Resources For Congestive Heart Failure
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This article is not medical advice. It is intended for general informational purposes and is not meant to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.
Doses Of Investigational Drugs In Phase Iii Clinical Trials
While target doses of the investigational agent are specified per protocol in phase III trials and generally achieved in the majority of patients, there are some patients who are unable to tolerate such doses . The Studies of Left Ventricular Dysfunction Prevention trial in asymptomatic patients with an EF 35% targeted 20 mg but achieved only 12.7 mg daily of enalapril. Inability to reach target dose was driven by dizziness, cough, and hypotension. The SOLVD Treatment trial demonstrated a significant reduction in mortality with enalapril after achieving 16.6 mg daily dose while targeting 20 mg daily, a dose that was achieved in less than half the participants. Side effects were reported in 87% of the patients with enalapril, but high rates of side effects were also reported with placebo . Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart failure showed a mortality reduction of 31% when targeting 200 mg/day. This was achieved in 64% of patients and the mean dose was 159 mg/day. In the Carvedilol Prospective Randomized Cumulative Survival Study trial, 4 in 5 patients were able to reach the target dose of 50mg daily. Further, side effects reported with carvedilol were actually significantly less than those reported with placebo.
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How Is Congestive Heart Failure Diagnosed
Congestive heart failure is diagnosed primarily from a history and a physical examination. A primary care physician may be the first healthcare professional to recognize symptoms during a routine physical, but a cardiologist will make the final diagnosis.
A medical history will help identify risk factors such as high blood pressure, smoking, obesity, lack of exercise, and diabetes. Be prepared to answer questions like:
- Is there a family history of congestive heart failure?
- Are you short of breath?
- Have you been fatigued or unable to do physical work?
- If you have swelling or edema, when did it start?
- Have you had chest pain?
Research has shown that the most accurate indicators of heart failure are physical symptoms, so a physical exam is the most important diagnostic tool. Symptoms are due to either reduced heart pumping volume or swelling and fluid retention . Heart failure symptoms include:
- Shortness of breath especially when lying down
- Weakness
- Nausea
- Lowered appetite
The doctor will also take your pulse and listen to the heart to identify distinctive symptoms of heart failure:
- Alternating weak and strong pulse
- A shift in the location of the maximum pulse that can be felt on the chest surface
- Presence of a brief vibration that can be heard through a stethoscope as one of the ventricles fills with blood, called the S3 gallop
In addition to a physical exam, the cardiologist will use tests to confirm the diagnosis:
Treatment will depend on the conditions stage.
Congestive Heart Failure: Prevention Treatment And Research
Congestive heart failure is a serious condition in which the heart doesnt pump blood as efficiently as it should. Despite its name, heart failure doesnt mean that the heart has literally failed or is about to stop working. Rather, it means that the heart muscle has become less able to contract over time or has a mechanical problem that limits its ability to fill with blood. As a result, it cant keep up with the bodys demand, and blood returns to the heart faster than it can be pumped outit becomes congested, or backed up. This pumping problem means that not enough oxygen-rich blood can get to the bodys other organs.
The body tries to compensate in different ways. The heart beats faster to take less time for refilling after it contractsbut over the long run, less blood circulates, and the extra effort can cause heart palpitations. The heart also enlarges a bit to make room for the blood. The lungs fill with fluid, causing shortness of breath. The kidneys, when they dont receive enough blood, begin to retain water and sodium, which can lead to kidney failure. With or without treatment, heart failure is often and typically progressive, meaning it gradually gets worse.
More than 5 million people in the United States have congestive heart failure. Its the most common diagnosis in hospitalized patients over age 65. One in nine deaths has heart failure as a contributing cause.
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