More than six million American adults suffer from heart failure. But, while the prevalence of this disease has increased over time, there are signs that deaths from it have not and hospitalization rates may be stabilizing as well. Healthcare professionals say this is good news and the future looks even more promising.
"Despite the increasing number of people affected, the prognosis for patients with heart failure has steadily improved," said Gregg C. Fonarow, M.D, chairman of American Heart Association Hospital Accreditation Science Committee and professor of cardiovascular medicine of the University of California, Los Angeles. "This is testament in part to better therapies and systems for treating this condition. There has been so much research and advancement in this area that what used to be a very dismal diagnosis is no longer the norm. Used appropriately, available medical and device therapies are even more effective than originally believed and best practices of care have now been shown to save lives."
Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through the heart to meet the body's needs for blood and oxygen. Basically, the heart can't keep up with its workload.
The weakened heart can't supply the cells with enough blood. This results in fatigue and shortness of breath. Everyday activities such as walking, climbing stairs or carrying groceries can become difficult.
Heart failure is caused by damage to the heart that impairs its ability to function. However, even for the patient with chronic heart muscle weakness, a significant amount of heart function can now be restored by the correct use of heart failure medication and devices.
"Even for our patients with advanced disease, there are so many more options now available to us," said Clyde Yancy, M.D., past president of the American Heart Association and chief of the Division of Cardiology and the Magerstadt Professor at Northwestern University Feinberg School of Medicine in Chicago. "The use of mechanical support such as artificial heart pumping devices, has become remarkable. We can sustain patients long enough to not only allow for heart transplantation but also to serve as definitive therapy and even more provocatively to support recovery of heart muscle function even when seemingly dramatic changes have taken place."
Along with advanced technologies, improvements in quality of care are also making a difference in heart failure outcomes.
Studies have shown that heart failure patients treated with American Heart Association/American College of Cardiology guideline-recommended therapies are more likely to survive over the next two years. Every10 percent improvement in the use of guideline-recommended therapies has been associated with a 13 percent lower risk of death among heart failure patients over the next two years.
Recent studies also show that patients treated in hospitals participating in the American Heart Association's Get With The Guidelines®-Heart Failure program receive higher quality of care and may experience better outcomes.
Hospital readmissions after treatment for heart failure have been a growing and costly issue in the past. But Fonarow said greater use of guideline-recommended therapies, improved care transitions and enhanced participation in quality improvement efforts are key to turning this around.
"It's important for a heart failure patient ― and their caregivers ― to be aware of what's going on with their body during recovery and beyond and to quickly deal with any new or fluctuating symptoms," he said. "Sometimes a quick and early call to your healthcare provider can make a big difference in getting you back on track rather than dismissing those symptoms until they require more drastic treatment, including hospitalization."
That's a goal of one of the American Heart Association's latest quality campaigns ― Target: Heart Failure. The initiative provides healthcare professionals with content-rich resources and materials designed to help them improve heart failure awareness, prevention, treatment and recovery.
Yancy said many people with heart failure are actually able to lead a full, enjoyable life when the condition is managed with correct medications and devices and with healthy lifestyle changes. Successful treatment depends on the willingness of patients and caregivers to get involved in managing the condition.
"But what's most encouraging to me is what we've learned about the prevention of heart failure," he said. "The effective treatment of high blood pressure and reduction of known risk factors for coronary artery disease will indeed prevent heart failure from occurring. That's the best treatment ― to never have heart failure."
"The present environment for heart failure is much better than ever before and the future holds promises that will truly remove 'failure' from our description of this illness," Fonarow said.
- G. C. Fonarow, N. M. Albert, A. B. Curtis, M. Gheorghiade, J. T. Heywood, Y. Liu, M. R. Mehra, C. M. O'Connor, D. Reynolds, M. N. Walsh, C. W. Yancy. Associations Between Outpatient Heart Failure Process-of-Care Measures and Mortality. Circulation, 2011; 123 (15): 1601 DOI: 10.1161/CIRCULATIONAHA.110.989632
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