| Wake
Forest
University
Baptist
Medical
Center
Little-Understood
Form
of
Heart
Failure
Common
Among
Elderly
A
study
of
almost
5,000
older
adults
living
in
four
U.S.
communities
showed
that
more
than
half
of
those
with
heart
failure
had
a
little-understood
form
of
the
disorder
that
doctors
know
little
about
treating,
report
researchers
in
this
week's
American
Journal
of
Cardiology.
"Our
study
suggests
that
a
large
proportion
of
older
adults
with
heart
failure
have
a
recently
recognized,
little-understood
form
of
the
disorder,
and
that
it's
especially
common
among
women,"
said
Dalane
W.
Kitzman,
M.D.,
associate
professor
of
cardiology
at
Wake
Forest
University
Baptist
Medical
Center
(WFUBMC)
and
the
study's
main
author.
"The
implications
to
public
health
are
enormous."
Doctors
previously
believed
that
most
heart
failure
was
a
weakening
of
the
heart
muscle
that
kept
it
from
pumping
enough
blood
(systolic
heart
failure).
In
recent
years,
however,
a
second
form
has
been
recognized:
the
heart
can
empty
normally,
but
the
main
pumping
chamber
doesn't
fill
with
enough
blood
(diastolic
heart
failure).
The
result
is
the
same
-
the
body
does
not
get
enough
oxygen-rich
blood
for
its
needs.
The
most
common
symptom
is
shortness
of
breath.
This
was
the
first
large,
community-based
study
of
heart
failure
among
older
adults.
It
was
conducted
by
researchers
from
WFUBMC
as
well
as
the
University
of
California
at
Irvine,
St.
Francis
Hospital
in
Roslyn,
New
York,
the
University
of
Washington
at
Seattle,
the
University
of
Massachusetts
Medical
Center,
the
University
of
Vermont
in
Burlington
and
the
University
of
Arizona
at
Tuscon.
"For
years,
we
focused
on
systolic
heart
failure
as
though
it
was
the
only
kind
that
existed,"
said
Kitzman.
"Now,
through
our
study
and
others,
we're
realizing
that
diastolic
failure
may
be
the
more
common
form
among
older
adults,
especially
women."
The
researchers
studied
4,842
participants
who
were
66
and
older.
Of
those,
425
(8.8
percent)
had
a
confirmed
history
of
congestive
heart
failure.
To
determine
each
person's
type
of
heart
failure,
ultrasound
technology
was
used
to
measure
the
percentage
of
blood
the
heart
emptied
with
each
beat.
A
normal
heart
can
pump
50
percent
or
more
of
its
volume
with
each
beat.
The
study
found
that
more
than
half
(55
percent)
of
participants
with
congestive
heart
failure
had
normal
emptying
and
could
be
diagnosed
with
diastolic
dysfunction
-
the
second
type
of
heart
failure.
Among
women
with
heart
failure,
67
percent
had
diastolic
failure,
compared
to
42
percent
of
men.
"The
majority
of
older
adults
did
not
have
the
type
of
heart
failure
that
has
been
well-researched
for
the
past
30
years,"
said
Kitzman.
"Instead,
they
had
a
type
that
we
don't
fully
understand
its
cause,
how
it
progresses
or
how
to
best
treat
it.
The
implications
are
enormous
considering
that
heart
failure
is
the
number
one
cause
of
hospitalization
for
people
age
65
and
older
in
the
United
States."
The
research
was
part
of
the
large
multi-center
Cardiovascular
Health
Study
of
cardiovascular
disease
risk
in
the
elderly.
Sponsored
by
the
National
Heart,
Lung
and
Blood
Institute,
the
study
followed
residents
in
four
communities
(Forsyth
County,
N.C.,
Sacramento
County,
Calif.,
Allegheny
County,
Penn.,
and
Washington
County,
Md.)
for
10
years.
In
the
United
States,
about
5
million
people
have
heart
failure
and
an
additional
550,000
are
diagnosed
with
it
annually.
It
is
one
of
the
largest
health
problems
in
the
developed
world.
The
standard
treatments
for
systolic
heart
failure
include
water
pills,
blood
thinners
and
medications
that
cause
the
blood
vessels
to
widen
or
increase
the
force
of
the
heart's
contractions.
Researchers
are
currently
evaluating
the
best
treatments
for
diastolic
heart
failure.
WFUBMC
is
conducting
five
studies
to
evaluate
several
drugs
(angiotensin-converting-enzyme
inhibitors
and
angiotensin
receptor
blockers)
and
exercise
as
treatments
for
the
disorder. |