Mediaplanet Who is most susceptible to heart failure?

Dr. Justin Ezekowitz Patients with hypertension, diabetes, coronary artery disease, those over 65 years of age. Also, those receiving chemotherapy for cancer and with heart rhythm problems such as atrial fibrillation.

Dr. Vivek Rao The take home message is that anyone can get heart failure. Its most common cause in the Canadian population is coronary artery disease and the various conditions associated with heart attacks. Thus, smoking, obesity, hypertension, hyperlipidemia, and diabetes are the risk factors that predict those most at risk for heart failure.

Patients with diabetes, obesity, and hypertension can also develop heart failure in the absence of any coronary artery disease. Likewise, anyone can suffer from a viral infection that results in heart failure. While rare, thankfully, a viral infection does not have a predilection for any patient subset.

MP What factors can contribute or lead to heart failure?

JE Poor diet and limited exercise; as well, poorly controlled diseases previously mentioned.

VR Diabetes, hypertension, obesity can independently lead to heart failure. Patients who have valvular heart disease or cardiac arrhythmias that are not appropriately treated can also develop it.

MP How has the way heart failure is treated changed over time?

"We’re also finding new ways to treat patients with exercise, diet, and focusing more on the quality of life than before."

JE In the 1980s we had virtually no therapies. Then along came a number of medications that reduced the chances of dying, being hospitalized, or improved the quality of life significantly. In addition, improvements in pacemakers, defibrillators, as well better focus on care teams (such as heart function clinics) have all helped improve quality of life, and reduce the chances of dying or being hospitalized.

That said, we have a long way to go in modifying the treatment of patients seen in the E.R. with acute heart failure, and for those who have chronic heart failure or remain quite ill despite the best medical therapies. We’re also finding new ways to treat patients with exercise, diet, and focusing more on the quality of life than before.

VR We now have very sophisticated blood tests to objectively measure the degree of heart failure: for example, brain natriuretic peptide (BNP). In addition, there are more specialized outpatient heart failure clinics in more communities. Lastly, there have been tremendous advances in heart transplantation and artificial heart technology — addressing the needs of patients with severe or advanced heart failure.