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Heart Failure

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Types of Heart failure
The term Congestive heart failure is often used to describe all patients with Heart failure. In reality, congestion (the build up of fluid) is just one feature of the condition and does not occur in all patients. There are two main categories of Heart failure–Systolic and Diastolic. However, within each category, symptoms and effects may differ from patient to patient.

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The two categories are
Systolic heart failure
This occurs when the heart’s ability to contract decreases. The heart cannot pump with enough force to push a sufficient amount of blood into the circulation. Blood coming into the heart from the lungs may back up and cause fluid to leak into the lungs, a condition known as Pulmonary Congestion.

Diastolic heart failure
This occurs when the heart has a problem relaxing. The heart cannot properly fill with blood because the muscle has become stiff, losing its ability to relax. This form may lead to fluid accumulation, especially in the feet, ankles, and legs. Some patients may have lung congestion.

Percentage of persons with Heart failure
Between 2 to 3 million Americans have heart failure, and 400,000 new cases are diagnosed each year. The condition is slightly more common among men than women and is twice as common among African Americans as whites.
Heart failure causes 38,000 deaths a year and is a contributing factor in another 225,000 deaths. The death rate attributed to heart failure has doubled since 1968, in contrast to a greater than 50% decrease in Coronary disease mortality during the same period. Heart failure mortality is twice as high for African Americans as whites for all age groups.

In a sense, Heart failure’s growing presence as a health problem reflects the Nation’s changing population: More people are living longer. People aged 65 and older represent the fastest growing segment of the population, and the risk of Heart failure increases with age. The condition affects 1% of people aged 50–59, but 10% of people aged 80–89.

Causes of Heart failure
As stated, the heart loses some of its blood–pumping ability as a natural consequence of aging. However, a number of other factors can lead to a potentially life–threatening loss of pumping activity. As a symptom of underlying heart disease, heart failure is closely associated with the major risk factors for coronary heart disease: Smoking, High cholesterol levels, Hypertension (persistent high blood pressure), Diabetes and abnormal Blood sugar levels, and Obesity. A person can change or eliminate those risk factors and thus lower their risk of developing or aggravating their heart disease and heart failure.

Among prominent risk factors, Hypertension (High blood pressure) and Diabetes are particularly important. Uncontrolled high blood pressure increases the risk of heart failure by 200%, compared with those who do not have Hypertension. Moreover, the degree of risk appears directly related to the severity of the high blood pressure. Persons with diabetes have a three–to–eight fold greater risk of heart failure than those without diabetes. Women with diabetes having a greater risk of heart failure than men with diabetes. Part of the risk comes from Diabetes’ association with other heart failure risk factors, such as high blood pressure, obesity, and high cholesterol levels. However, the disease process in diabetes also damages the heart muscle.

The presence of Coronary disease is among the greatest risks for heart failure. Muscle damage and scarring caused by a heart attack greatly increase the risk of heart failure. Cardiac Arrhythmias, or Irregular heartbeats, also raise heart failure risk. Any disorder that causes abnormal swelling or thickening of the heart sets the stage for heart failure. In some people, heart failure arises from problems with heart valves, the flap–like structures that help regulate blood flow through the heart. Infections in the heart are another source of increased risk for heart failure.

A single risk factor may be sufficient to cause heart failure, but a combination of factors dramatically increases the risk. Advanced age adds to the potential impact of any heart failure risk. Finally, genetics contributes to the risk for certain types of heart disease, which in turn may lead to heart failure. However, in most instances, a specific genetic link to heart failure has not been identified.

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