Too young for heart failure

Why more Americans under 65 are being diagnosed with heart failure earlier in life

Heart failure, also called congestive heart failure (CHF), is when the heart doesn’t pump blood as well as it needs to. While more than 200,000 cases are diagnosed every year, heart failure is typically found in patients over 65. The Journal of the American College of Cardiology published a article this summer that highlighted the rise in heart failure cases in people under the age of 65. According to experts, this is partially due to a “clustering of risk factors” in young adults, such as hypertension, high blood pressure, rising rates of obesity, and coronary artery disease.

The term heart failure is easily confused with cardiac arrest, which is when your heart suddenly stops beating. Heart failure is the result of long-term heart disease, like coronary artery disease, the buildup a fatty plaque in your arteries that can reduce blood flow, cause strain on your heart muscle, and trigger a heart attack. “What we also look for in heart failure patients is what caused the heart to get weak in the first place,” said Dr. Heather Stahura, a board-certified cardiologist at Capital Cardiology Associates. “Very infrequently, but it can happen, some medications can cause acute CHF. Some chemotherapies can cause heart failure to happen. In other people, once in a while, we’ll see a common cold virus that can attack the heart, making it function poorly. Most of the time, we see CHF as a continuum of a long-term process that stems from uncontrolled high blood pressure, cholesterol, and what I am seeing with young adults — hypertension.”

Heart failure risk for young adults

Researchers recently looked at the relationship between high cholesterol and blood pressure levels in early adulthood and the impact on heart health later in life. Their findings, published in the Journal of The American College of Cardiology found that “exposure to elevated (levels) during young adulthood (18 to 39 years of age) were associated with increased coronary heart disease and heart failure later in life.” The doctors cautioned young people that high blood pressure, diabetes, and smoking are modifiable risk factors, meaning that while genetics ultimately play a key role in your overall heart health, a healthy lifestyle can combat some risks. “What I am seeing with young adults is hypertension. They may be diagnosed with diabetes in their 30’s or 40’s and feel that a blood pressure reading of 170 is something they can take care of when they are older. But ten years or more of high blood pressure can weaken the heart and cause congestive heart failure,” noted Dr. Stahura.

Since heart failure is a long-term disease, daily activities like walking up the stairs, carrying groceries, or even walking from your car to your home can, over time, become a challenge. “The biggest symptoms that we see as cardiologists are shortness of breath either at rest or on exertion,” shared Dr. Stahura. “Fatigue, that’s the other symptom I see in a lot of people. Not being able to get out of bed, lacking the energy to play with your grandkids, loss of interest in things you used to do. Swelling in your lower extremities is something I will investigate. A little swelling around the ankles is common at the end of the day, but we’re talking about excessive swelling. Increase abdominal wall growth, where your pants are fitting tighter, could be an option. In advanced stages of congestive heart failure (CHF) where it is filling up your lungs, you can have pulmonary edema — fluid in your lungs — that can make breathing more difficult.”

The danger of heart failure is that there is no cure. This is why health care professionals stress the importance of regular visits with your doctor to monitor your risk, and if needed, recommend lifestyle changes to improve your heart health. It is possible to live with heart failure. Of the more than 6 million American adults living with heart failure, about 10 percent have advanced heart failure. Dr. Stahura outlined those treatment options. “There is a biventricular pacemaker that some patients respond well too. My electrophysiology colleagues at CCA would implant this device to try and re-synchronize the heart if the patient meets certain criteria. Our interventionists can place a mitral clip, a procedure where we cinch a very leaky heart valve. If you have a tight or stenotic heart value, like aortic stenosis, we will insert a TAVR valve, that alleviates the stress in your heart. We have plenty of options for each heart failure case. But always diet, exercise, and medication will be the cornerstone of therapy.”

Written by Michael Arce, Marketing Coordinator, Capital Cardiology Associates
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