CONGESTIVE HEART FAILURE
Congestive heart failure (CHF), known simply as heart failure, occurs when your heart can’t pump enough blood to meet your body’s needs. CHF often results from other heart conditions, such as coronary artery disease or high blood pressure, which over time can damage and weaken the heart. When the heart can no longer pump blood efficiently through your body, blood and fluids back up into the circulatory system, causing swelling in your lungs, legs, feet, and ankles and congestive symptoms such as shortness of breath.
Heart failure can develop suddenly due to damage caused by a heart attack, or it can develop gradually after years of having high blood pressure, coronary artery disease, or a defective heart valve. A number of lifestyle factors contribute to heart failure such as smoking, obesity, and diet. In some cases, though, the heart becomes weakened without explanation. This is called idiopathic dilated cardiomyopathy.
Heart failure is treatable with medication and lifestyle modifications. In many cases it is possible to prevent heart failure by controlling the risk factors that damage the heart. Maintaining a healthy diet, exercising regularly, not smoking, and reducing stress can help significantly. There are also a variety of supplements that can strengthen the function of the heart.
SIGNS & SYMPTOMS
Difficulty in concentrating or decreased alertness
Fatigue and weakness
Irregular or rapid heartbeat
Lack of appetite and nausea
Persistent cough or wheezing
Reduced ability to exercise
Shortness of breath when you exert yourself or lie down
Sudden weight gain from fluid retention
Swelling in your legs, ankles, feet, or abdomen
ACUTE HEART FAILURE
Acute heart failure occurs when something suddenly affects your heart’s ability to function, such as a heart attack, a virus that attacks the heart muscle, severe infections, an allergic reaction, or a blood clot in the lungs. Signs and symptoms are similar to those of chronic heart failure, but are more severe and start suddenly. Acute heart failure can trigger a rapid heartbeat and abnormal rhythm. This requires immediate medical attention.
RISK FACTORS
Alcohol weakens the heart muscle.
Arrhythmia, an abnormal heartbeat, weakens the heart.
Congenital heart defects.
Coronary artery disease: Plaque buildup causes the arteries to narrow, which limits the heart’s supply of oxygen-rich blood.
Diabetes increases the risk of high blood pressure and coronary artery disease.
Heart attack damages the heart muscle.
High blood pressure forces the heart to work harder.
Kidney disease can cause high blood pressure and fluid retention, which contributes to heart failure.
Obesity.
Sleep apnea, an inability to breathe properly at night, results in low blood oxygen levels and increased risk of abnormal heart rhythms.
Viral infection can damage the heart muscle.
DOCTOR’S ORDERS
Heart failure is a serious disease that requires medical care. Your doctor will recommend a combination of lifestyle measures and medications to help improve the strength of the heart and reduce symptoms of heart failure. Commonly used medications include:
Angiotensin-converting enzyme (ACE) inhibitors: Vasodilator drugs that widen or dilate blood vessels to lower blood pressure, improve blood flow, and decrease the workload on the heart. Examples include enalapril (Vasotec), lisinopril (Prinivil, Zestril), and ramipril (Altace). A major unpleasant side effect of these drugs is chronic cough.
Angiotensin II (A-II) receptor blockers (ARBs): Work the same as the drugs above, but do not cause coughing. Examples include losartan (Cozaar) and valsartan (Diovan).
Beta blockers: Slow your heart rate and reduce blood pressure. Examples include carvedilol (Coreg), metoprolol (Lopressor), and propranolol (Inderal).
Digoxin (Lanoxin): Increases the strength of your heart muscle contractions and slows the heartbeat.
Diuretics: Commonly called water pills, diuretics make you urinate more frequently and keep fluid from collecting in your body. Examples include furosemide (Lasix) and spironolactone (Aldactone).
In some cases, surgery can be done to correct the underlying problem, such as replacing a faulty heart valve, or doing bypass surgery on severely narrowed arteries. For those with severe heart failure that can’t be helped by surgery or medications, a heart transplant may be necessary.
The key to managing or preventing heart failure is to get the risk factors under control, namely, high blood pressure and coronary artery disease. In this section I outline dietary, lifestyle, and supplement strategies that help improve heart function.
Dietary Recommendations
Foods to include:
• Cold-water fish contains beneficial fatty acids that can help reduce blood pressure and cholesterol.
• Drink green tea, which contains antioxidants that offer benefits for the heart.
• Eat small, frequent meals. Overeating is hard on the heart.
• Garlic and onions contain antioxidants that help lower blood pressure and cholesterol.
• Soy foods can help lower blood pressure. Incorporate soy milk, tofu, soy protein, and soy nuts into your diet.
• Whole grains, vegetables, fruits, beans, and legumes contain lots of fibre along with essential nutrients, which help lower blood pressure and cholesterol.
Foods to avoid:
• Alcohol can weaken heart function and interacts negatively with many heart medications. Avoid or limit alcohol to one drink per day.
• Caffeine can increase heart rate and affect heart rhythm.
• Saturated fat (red meat and dairy) and trans fats can increase cholesterol and the risk of coronary heart disease.
• Sodium (salt) can cause water retention and worsen heart failure. Limit sodium intake to 2,000 mg per day. Foods high in sodium include snack foods (chips, pretzels), deli meats, soft drinks, and fast foods. Don’t add salt to your foods—season with herbs instead.
Note: Those with heart failure may need to limit fluid intake to prevent water retention. Speak with your doctor about this.
Lifestyle Suggestions
• Don’t smoke, and avoid second-hand smoke. Tobacco damages blood vessels, reduces the oxygen in your blood, and makes your heart beat faster.
• Maintain a healthy body weight. Being overweight increases stress to the heart.
• Get regular, moderate-intensity exercise, such as walking or swimming. Studies have shown that exercise can improve quality of life and function in those with CHF.
• Manage your stress. Stress increases heart rate and blood pressure, straining the heart. Try yoga, acupuncture, and meditation.
• Get adequate sleep at night (seven to nine hours). If you have shortness of breath during the night, prop up your pillow.
Top Recommended Supplements
Coenzyme Q10: An antioxidant that naturally occurs in all cells and is involved in energy production. People with CHF have lower levels of Q10. Several studies have shown that supplements can significantly improve CHF symptoms and quality of life. Dosage: 100-300 mg daily.
Hawthorn: Improves the heart’s pumping ability and improves blood flow. Numerous studies have found that it can reduce symptoms of CHF and improve exercise capacity. Some research suggests that it may also help to prevent arrhythmias. Dosage: 300-600 mg three times daily.
L-carnitine: An amino acid naturally found in all cells. It helps the heart contract and produce energy more efficiently. Studies show that it improves heart function and can reduce the symptoms of CHF. Dosage: 1,000 mg three times daily.
Complementary Supplements
Calcium and magnesium: Essential for proper muscle contractions and blood vessel health. Levels of calcium and magnesium are depleted by diuretics and digoxin, commonly used CHF drugs. Several studies have found that these minerals can promote modest reductions in blood pressure and improve CHF. Magnesium can also help prevent abnormal heart rhythm. Dosage: 1,500 mg calcium and 500 mg magnesium daily. Take in divided dosages with meals.
Fish oils: Over 30 studies have shown that the omega-3 fatty acids in fish oil can help lower blood pressure, reduce atherosclerosis, and protect against heart attack. Dosage: 3 g of EPA plus DHA three times daily.
Garlic: Helps lower blood pressure and cholesterol, reduces clotting, and prevents plaque formation in the arteries. Most of the research showing benefits has been done on aged garlic extract (Kyolic). Dosage: 600 mg twice daily.
L-taurine: An amino acid that helps increase the force and effectiveness of heart-muscle contractions. Research has shown that taurine can reduce the symptoms of CHF. Dosage: 2 g three times daily.
Natural relaxants: Hops, lemon balm, passionflower, and valerian are herbs that can help promote calming, which can help those under stress. Lactium (milk protein extract) and Suntheanine (green tea extract) are also effective in promoting calming, reducing stress, and improving sleep. Dosage: Follow product label instructions.
Vitamin B1: Required for energy production in the cells of the heart. Taking diuretics depletes levels of vitamin B1, and studies have shown that vitamin B1 supplements can improve heart function and symptoms of CHF. Dosage: 100 mg daily as part of a B-complex.
FINAL THOUGHTS
To improve the management of CHF, consider the following:
1. Boost intake of fibre, fish, flaxseed, soy, garlic, and green tea.
2. Minimize intake of sodium, alcohol, caffeine, and saturated fat. Speak with your doctor about guidelines for fluid intake.
3. Don’t smoke.
4. Get regular exercise and reduce your stress.
5. Consider supplements of coenzyme Q10, hawthorn, and L-carnitine.
