‘One in five people aged over 40 will develop heart failure in their lifetime,” says Dr. Alex T. Junia, the president of the Philippine Heart Association (PHA).
And the number of Filipinos with heart failure is increasing. “Half of all patients will die within five years of being diagnosed with heart failure,” Junia points out.
Among people aged over 65, heart failure is the most common cause of hospitalization.
“Heart failure or palyadong puso in the vernacular is a silent killer that has been creeping in our midst,” Junia says.
Unfortunately, there are currently no definitive local statistics on the prevalence of heart failure. However, the latest National Nutrition and Health Survey conducted in 2013 show that many Filipinos have risk factors for heart failure. These include hypertension, obesity, smoking, high cholesterol and diabetes.
Heart failure, sometimes known as congestive heart failure, occurs when the heart muscle doesn’t pump blood as well as it should. Certain conditions, such as narrowed arteries in your heart (coronary artery disease) or high blood pressure, gradually leave the heart too weak or stiff to fill and pump efficiently.
“In heart failure, the main pumping chambers of your heart (the ventricles) may become stiff and not fill properly between beats,” the Minnesota-based Mayo Clinic explains. “In some cases of heart failure, your heart muscle may become damaged and weakened, and the ventricles stretch (dilate) to the point that the heart can’t pump blood efficiently throughout your body. Over time, the heart can no longer keep up with the normal demands placed on it to pump blood to the rest of your body.”
An ejection fraction is an important measurement of how well your heart is pumping and is used to help classify heart failure and guide treatment. “In a healthy heart, the ejection fraction is 50 percent or higher — meaning that more than half of the blood that fills the ventricle is pumped out with each beat,” the Mayo Clinic says. “But heart failure can occur even with a normal ejection fraction. This happens if the heart muscle becomes stiff from conditions such as high blood pressure.”
The term “congestive heart failure” comes from blood backing up into — or congesting — the liver, abdomen, lower extremities and lungs. “However, not all heart failure is congestive,” reminds the Mayo Clinic. “You might have shortness of breath or weakness due to heart failure and not have any fluid building up.”
According to Mayo Clinic says heart failure can be ongoing (chronic), or the condition may start suddenly (acute).
Among the signs and symptoms of heart failure are as follows: shortness of breath (dyspnea) when you exert yourself or when you lie down; fatigue and weakness; swelling (edema) in your legs, ankles and feet; rapid or irregular heartbeat; reduced ability to exercise; persistent cough or wheezing with white or pink blood-tinged phlegm; increased need to urinate at night; swelling of your abdomen (ascites); sudden weight gain from fluid retention; lack of appetite and nausea; difficulty concentrating or decreased alertness; sudden, severe shortness of breath and coughing up pink, foamy mucus; and chest pain) if your heart failure is caused by a heart attack).
There are several conditions which can damage or weaken your heart and can cause heart failure. Some of these can be present without your knowing it. In high blood pressure, for instance, the heart works harder than it has to. When you have coronary artery disease, the narrowed arteries may limit your heart’s supply of oxygen-rich blood, resulting in weakened heart muscle.
Having diabetes increases your risk of high blood pressure and coronary artery disease. And if you are taking some diabetes medications, there are those that have been found to increase the risk of heart failure in some people. “Don’t stop taking these medications on your own, though,” the Mayo Clinic warns. “If you’re taking them, discuss with your doctor whether you need to make any changes.”
If you are suffering from sleep apnea, the inability to breathe properly while you sleep at night results in low blood oxygen levels and increased risk of abnormal heart rhythms. Both of these problems can weaken the heart.
In some people who develop heart failure, they were born with structural heart defects. And people with valvular heart disease have a higher risk of heart failure. Also, a viral infection may have damaged your heart muscle.
Irregular heartbeats, especially if they are very frequent and fast, can weaken the heart muscle and cause heart failure. On the other hand, damage to your heart muscle from a heart attack may mean your heart can no longer pump as well as it should.
Drinking and smoking can also cause heart failure. Drinking too much alcohol can weaken heart muscle and lead to heart failure. Using tobacco can increase your risk of heart failure.
Several studies have shown that people who are obese have a higher risk of developing heart failure.
“Over time, if not treated properly, heart failure leads to a cascade of changes, punctuated by acute episodes, that cause severe fatigue; breathlessness; damage particularly to the heart, kidneys and liver; and ultimately death,” Junia warns.
So, you better watch out. “Not all conditions that lead to heart failure can be reversed, but treatments can improve the signs and symptoms of heart failure and help you live longer,” the Mayo Clinic says. “Lifestyle changes — such as exercising, reducing salt in your diet, managing stress and losing weight — can improve your quality of life.”