Reducing the risk of coronary artery disease

Q. What exactly is congestive heart failure?

If you have congestive heart failure (CHF), your heart can’t pump enough blood. This condition develops over time. It is the number one reason people over age 65 go into the hospital.

Heart failure is most common in older people and is more common in African-Americans. 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 oxygenpoor blood from the body to the right side of the heart. It is then pumped through the pulmonary artery to the lungs, where it picks up oxygen. From there, the blood returns to the left side of the heart. Then it is pumped through a large artery called the aorta that distributes blood throughout the body.

Heart failure is caused by other diseases or conditions that damage the heart muscle. It is often caused by coronary artery disease, including heart attacks. Diabetes and high blood pressure also contribute to heart failure.

Coronary artery disease is the leading cause of death in men and women. It happens 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 things that you can do to reduce risk of coronary artery disease and heart failure. For starters, you should keep the following levels down: body weight, cholesterol, blood pressure, sugar, alcohol and salt. Exercise regularly. And, if you smoke, quit.

The most common symptoms of heart failure include shortness of breath, fatigue and swelling, which usually occurs in the ankles, feet and legs. Swelling is caused by fluid buildup in the body and can lead to weight gain, frequent urination and a cough.

Because the symptoms are common for other conditions, your doctor will determine if you have heart failure by doing a detailed medical history, an examination and several tests.

Tests that are given to determine heart failure include an electrocardiogram (EKG), a chest X-ray and a blood test for BNP, a hormone that increases in heart failure.

Tests that can identify the cause of heart failure include an echocardiogram that uses 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; an exercise stress test that reads your EKG and blood pressure before, during or after exercise to see how your heart responds; and a coronary angiography, which is an X-ray of the heart’s blood vessels.

There is no cure for heart failure, but it can be controlled.

People with CHF are usually put on a low-salt diet to prevent fluid build-up. Their doctors may also tell them to lose weight, quit smoking and reduce alcohol intake.

Medications that are used include diuretics, “water pills” to reduce fluid; ACE inhibitors to lower blood pressure and reduce heart stress; beta-blockers to slow your heart rate and lower blood pressure; Digoxin to help the heart beat stronger; and anticoagulants (such as warfarin) that help prevent blood clots.

People with severe heart failure may also be given a mechanical heart pump. A heart transplant is an option when all other treatments fail to control symptoms.

Fred Cicetti is a freelance writer who specializes in health. He has been writing professionally since 1963. Before he began freelancing, he was a reporter and columnist for three daily newspapers in New Jersey. If you would like to ask a question, write to fred@healthygeezer.com.