Early-onset heart failure significantly elevates the risk of all-cause mortality. Research has shown that patients with heart failure under 55 years of age had the highest relative mortality risk, with a hazard ratio (HR) of 6.86 (95% CI 4.42-10.64) with respect to their matched controls[1].
Heart failure is a major public health issue with a prevalence of over 5.8 million in the USA and over 23 million worldwide, and rising. The lifetime risk of developing heart failure is one in five, and it carries substantial morbidity and mortality, with 5-year mortality rates that rival those of many cancers.
In general, more than half of all people with congestive heart failure survive for 5 years after diagnosis, and about 35% survive for 10 years. However, the 5-year death rate is estimated to be 75.4%.
Heart failure is a condition with an adverse prognosis, and 1-year mortality rates in population-based studies have been reported to be 35% to 40%.
What are the treatment options for heart failure.
The treatment options for heart failure include lifestyle changes, medications, devices, and surgical procedures. Lifestyle changes include avoiding smoking, eating a heart-healthy diet, and exercising regularly. Medications for heart failure include ACE inhibitors, angiotensin-2 receptor blockers (ARBs or AIIRAs), beta blockers, mineralocorticoid receptor antagonists, diuretics, ivabradine, sacubitril valsartan, hydralazine with nitrate, digoxin, and SGLT2 inhibitors. Devices implanted in the chest to control heart rhythm and surgery, such as heart valve surgery, may also be used to treat heart failure[2].
The specific treatment plan depends on the stage and type of heart failure, underlying conditions, and the individual patient. In many cases, a combination of treatments will be required, and treatment will usually need to continue for the rest of the patient’s life.
What are the potential side effects of heart failure medications
The potential side effects of heart failure medications can vary depending on the specific medication. Common side effects of heart failure medications include:
- ACE Inhibitors: Dry cough, dizziness, appetite loss, tiredness, headache, and high potassium levels in the blood, which can cause heart rhythm problems.
- Beta Blockers: Tiredness, dizziness, cold hands, weakness, and less commonly, shortness of breath, trouble sleeping, and depression. They can also trigger severe asthma attacks in people with asthma and may require more frequent blood sugar monitoring in people with diabetes.
- SGLT2 Inhibitors: Possible side effects include thrush, increased urination, mild skin rash, and back pain.
- Diuretics: Increased urination, dizziness, low blood pressure, dehydration, changes in kidney function, and increased blood sugar levels
- Mineralocorticoid Receptor Antagonists: Changes in kidney function, increased potassium levels, and swelling or tenderness in breasts (in men and women)
- Other Common Side Effects: Low blood pressure, irregular heartbeat, nausea, digestive problems, and potential interactions with other medications
It’s important for patients to discuss potential side effects with their healthcare provider and to report any unusual symptoms while taking heart failure medications. Some side effects may subside as the body adjusts to the medication, and healthcare providers can often adjust dosages or recommend strategies to manage side effects.
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