Heart Disease - Preventing Congestive Heart Failure (CHF)
Congestive heart failure (CHF) is typically due to a weakening of the heart over a long period of time. To help prevent heart failure, steps should be taken to prevent the diseases and conditions that cause CHF. These conditions include coronary artery disease (CAD), hypertension (high blood pressure), and diabetes. Maintaining a healthy diet and lifestyle can help reduce the chances of CHF. In addition, medications to help lower cholesterol and high blood pressure may also be prescribed.
Lifestyle factors that may reduce the risk of CHF:
- Healthy diet low in saturated fat, cholesterol and sodium
- Maintaining an ideal weight
- Exercising regularly
- Maintaining healthy blood pressure levels
Changing to a diet low in saturated fat and cholesterol, losing weight, and exercising regularly can lower cholesterol. When diet and lifestyle changes are not successful in lowering cholesterol, drug therapy may be considered. According to the American Heart Association, several factors should be taken into account when considering drug therapy for high cholesterol:
- Age (for men, 45 years or older; for women, 55 years or older OR premature menopause without estrogen replacement therapy)
- Family history of premature CAD (a father, brother or son with a history of CAD before age 55, OR a mother, sister or daughter with CAD before age 65)
- Smoking OR living or working every day with people who smoke
- High blood pressure (140/90 mm Hg or higher)
- HDL cholesterol less than 35 mg/dL
- Diabetes (fasting blood sugar of 126 mg/dL or higher)
The following chart summarizes types of drugs used to lower cholesterol and gives examples of specific generic/brand names. Brand names of drugs are shown in parentheses.
|Type of Drug||Examples|
|Bile acid sequestrants||cholestyramine (LoCHOLEST), colestipol (Colestid)|
|Nicotinic acid||niacin/vitamin B3|
|Statins||atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor)|
|Fibrates||gemfibrozil (Lopid), fenofibrate (Tricor) clofibrate (Atromid-S)
In some cases, combination drug therapy may be helpful in lowering cholesterol levels. For example, combining a bile acid sequestrant with either nicotinic acid or lovastatin may significantly lower LDL cholesterol.
Because hypertension (high blood pressure) signals atherosclerosis (narrowing of the arteries), steps should be taken to maintain healthy blood pressure levels before more serious problems occurs, such as hypertrophy (thickening of the heart muscle), dilated cardiomyopathy (dilation of the left ventricle), myocardial infarction (heart attack) or stroke. High blood pressure can be treated by reducing sodium intake and maintaining a diet rich in fruits, vegetable, and low-fat dairy products. Exercising, losing weight when appropriate, not smoking, and reducing stress can also reduce high blood pressure. When diet and lifestyle changes are not successful in treating high blood pressure, drug therapy should be considered.
The following chart summarizes types of drugs used to help lower blood pressure and gives examples of specific generic/brand names. Brand names are shown in parentheses. In some cases, combination drug therapy may be more effective at treating CAD than using a single drug.
|Type of Drug||Function||Examples|
|Beta blockers||reduce heartâ€™s workload||nadolol (Corgard), metoprolol (Lopressor, Toprol XL), pindolol (Visken), bisoprolol (Zebeta), acebutolol (Sectral).|
|Diuretics||rid body of excess fluid and salt||hydrochlorothiazide (HydroDIURIL), chlorothiazide (Diuril), furosemide (Lasix), bumetanide (Bumex), spironolactone (Aldactone), triamterene (Dyrenium), metolazone (Zaroxolyn).|
|ACE inhibitors||prevent blood vessel constriction||benazepril (Lotensin), lisinopril (Prinivil), captopril (Capoten), ramipril (Altace), fosinopril (Monopril), moexipril (Univasc).|
|Calcium channel blockers||increase blood flow through the heart and help prevent blood vessel constriction by blocking calcium ions||verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem, Tiamate, etc.), nifedipine (Adalat)|
Updated: February 2011