Q. One of my patients just asked an interesting question that I didn’t know the answer to. They asked, “What is the leading cause of hospitalization of older people?” Have any ideas?The No. 1 reason people over age 65 go into the hospital is congestive heart failure (CHF). Essentially, CHF patients’ hearts can’t pump enough blood; this condition develops over time.
CHF is most common in older people, and often occurs in African-Americans. In addition, men have a higher rate of heart failure than women. But, because women usually live longer, the condition affects more women in their 70s and 80s.
In normal hearts, veins bring oxygen-poor blood from the body to the right side of the heart. It is then pumped through the pulmonary artery to the lungs, picking up oxygen. From there, the blood returns to the left side of the heart. Then, it is pumped through the aorta, which distributes blood throughout the body.
Other diseases or conditions that damage the heart muscle result in cardiac failure. It is often caused by coronary artery disease, including heart attacks. Diabetes and high blood pressure also contribute to heart failure.
Furthermore, coronary artery disease is the leading cause of death in men and women. It occurs when the arteries that supply blood to the heart become hardened and narrowed. People who have had a heart attack are at high risk to develop heart failure.
There are a number of ways your patients can reduce their risk of developing coronary artery disease and heart failure. For starters, they should keep the following levels to a minimum: body weight, cholesterol, blood pressure, sugar, alcohol and salt. Also, exercising regularly and quitting smoking are keys to a healthy heart as well.
The most common symptoms of heart failure include shortness of breath, fatigue and swelling, which usually occurs in the lower extremities. Swelling is caused by fluid buildup in the body and can lead to weight gain, frequent urination and a cough.
To test patients for heart failure, physicians may prescribe an electrocardiogram (EKG), a chest X-ray and a blood test for BNP, which is a hormone that increases in heart failure.
Tests that can identify the cause of heart failure include: an echocardiogram utilizing sound waves; a Holter monitor, which is a small box that is worn for 24 hours to provide a continuous recording of heart rhythm during normal activity; and an exercise stress test that reads EKG and blood pressure levels before, during or after exercise to measure the heart’s response.
Although there is no cure for heart failure, it can be controlled.
People with CHF are usually put on a low-salt diet to prevent fluid build-up. Their physicians may also tell them to lose weight, quit smoking and reduce alcohol intake.
Some medications prescribed for CHF include: diuretics, “water pills” to reduce fluid; ACE inhibitors to lower blood pressure and reduce heart stress; beta-blockers to slow one’s heart rate and lower blood pressure; and Digoxin, which helps the heart beat stronger.
People with severe heart failure may also be given a mechanical heart pump. And, finally, a heart transplant is an option if all other treatments fail to control symptoms.
With experience as a freelance writer and publicist for major pharmaceutical companies, such as Eli Lilly, Johnson & Johnson, Merck and Pfizer, Fred Cicetti is now a New Jersey-based columnist writing about a variety of senior health issues. His opinions and views do not necessarily reflect those of Therapy Times or Valley Forge Publishing Group. Questions or comments can be directed to editorial@TherapyTimes.com.All Rights Reserved © 2006 by Fred Cicetti.
