Heart failure is a big deal.
Johns Hopkins University reports that It’s the most common diagnosis in hospitalized patients over the age of 65 in the United States, and 1 in 9 deaths has heart failure as a contributing cause.
Dr. Kevin R. Campbell, a cardiologist at Health First, explains, “Heart failure is a condition that occurs when the heart can’t pump blood normally. Patients feel short of breath and experience swelling, particularly in the lower legs, feet and hands.
“There are two different types,” Dr. Campbell adds. “In heart failure with reduced ejection fraction, the heart muscle is weak and does not squeeze out as much blood as it should.
“In heart failure with preserved ejection fraction, by contrast, the heart is squeezing normally but the muscle is stiff and can’t relax.”
Deaths from been climbing steadily nationwide since 2012, wiping out earlier declines. Duke University School of Medicine reports that the number of people dying from heart failure in the United States went down steadily from 1999 to 2009.
However, that progress began unraveling from 2009 to 2012 when heart failure-related mortality rates plateaued. From 2012 onwards, heart failure mortality rates have been increasing.
“There are several reasons for the increase,” says Dr. Campbell. “Rising rates of metabolic disorders like obesity, diabetes and high blood pressure are likely contributing. Greater awareness and better diagnosis of heart failure … [also may be adding to] the documented increase in deaths.”
Alcohol, as well as drugs like cocaine and methamphetamines, can be toxic to the heart and increase the risk for heart failure, says Dr. Michelle Kittleson, professor of cardiology at the Smidt Heart Institute at Cedars-Sinai in Los Angeles.
Dr. Sadiya Khan, a preventive cardiologist at the Feinberg School of Medicine at Northwestern University, adds that there are some additional risk factors specific to women, including menopause before age 45 and high blood pressure during pregnancy.
But the biggest factor, experts agree, is likely the rise in metabolic risk factors like obesity and diabetes mentioned by Dr. Campbell, which are occurring and in ever-younger patients. In 2021, there were nearly 48 heart failure deaths per 100,000 people ages 45 to 64, up from 32 in 2012.
Metabolic syndrome refers to the presence of a cluster of risk factors specific to cardiovascular disease.
According to the National Heart, Lung and Blood Institute (NHLBI), the cluster of metabolic factors involved includes:
- Abdominal obesity. Having a waist circumference of more than 35 inches for women and more than 40 inches for men. An increased waist circumference is the form of obesity most strongly tied to metabolic syndrome.
- High blood pressure. Normal blood pressure is 120/80 or lower.
- Impaired fasting blood glucose levels equal to or greater than 100 mg/dL.
- High triglyceride levels of more than 150 mg/dL.
- Low HDL (good) cholesterol. Less than 40 mg/dL for men and less than 50 mg/dL for women is considered low.
The latest findings by the Heart Failure Society of America (HFSA) reveal a concerning fact about the prevalence, mortality and impact of this debilitating condition. Approximately 6.7 million Americans over the age of 20 currently live with failing hearts, a figure projected to rise to 8.7 million by 2030, 10.3 million by 2040, and a staggering 11.4 million by 2050.
Although some of these people are born with congenital heart problems, contemporary lifestyles are a contributing factor. The American Heart Association list of habits that can increase your risk of heart failure includes:
- Smoking.
- Being overweight or obese.
- Eating foods high in saturated fat and cholesterol.
- Not being physically active.
Dr. Campbell says there are a variety of treatments available to treat heart failure.
“Pharmacological advances, including the drugs losartan, valsartan, lisinopril and Ozempic are some that are prescribed individually or in combination with other medications.
“Implantable cardioverter-defibrillators, also called ICDs, are battery-powered devices that are planted under the skin. Biventricular pacemakers are another implant option.”
He adds, “The role of a clinician like me is to keep you out of the hospital and feeling good for as long as I can.”
Kevin R. Campbell, MD, FACC, MBA, CPE, is a cardiologist at Health First in Melbourne. He completed fellowships at Duke University in Cardiovascular Disease and Cardiac Electrophysiology. He is a fellow of the American College of Cardiology. He has an MBA from his undergraduate alma mater, North Carolina State University. Call 321-442-9000 for an appointment.
