Preventing Heart Failure — A Serious and Increasingly Common Chronic Disease
ROCHESTER, Minn. — Heart failure happens when the heart can’t pump enough blood to meet the body’s needs. The American Heart Association says heart failure is a growing epidemic. The June issue of Mayo Clinic Health Letter covers some reasons for the increased prevalence of heart failure and options to help prevent it.
Heart failure often develops after the heart has been damaged or weakened by other conditions. The dramatic increase in heart failure coincides with an aging population, more people with heart disease and increased survival rates for those who experience heart attacks.
Over time, a heart that is compromised by underlying disease changes and loses function. The ventricles, the main pumping chambers, may become stiff and not fill properly between beats. The heart muscle may weaken. The ventricles can stretch, decreasing pumping efficiency. High blood pressure, faulty heart valves, abnormal heart rhythms, diabetes and other factors also can contribute to heart failure. Signs and symptoms of heart failure can include shortness of breath and leg swelling.
Medication may be necessary to treat underlying conditions that increase the risk of heart failure. There are many options, including:
- Angiotensin-converting enzyme (ACE) inhibitors — These medications relax the blood vessels to lower blood pressure, improve blood flow and decrease the heart’s workload. Examples include enalapril (Vasotec), lisinopril (Prinivil, Zestril) and captopril (Capoten).
- Angiotensin II receptor blockers (ARBs) — ARBs offer many of the same benefits as ACE inhibitors and are an option when ACE inhibitors aren’t well tolerated. Options include losartan (Cozaar), valsartan (Diovan) and others.
- Digoxin (Lanoxin) — This medication improves the strength of heart muscle contractions and tends to slow the heartbeat.
- Beta blockers — These drugs slow the heart rate, reduce blood pressure and may reduce the risk of some abnormal heart rhythms. Examples include bisoprolol (Zebeta), carvedilol (Coreg) and metoprolol (Lopressor).
- Diuretics — These medications cause frequent urination, keeping fluids from collecting in the body. Examples include bumetanide (Bumex), furosemide (Lasix) and hydrochlorothiazide.
Adopting a healthier lifestyle can help prevent heart failure. Important lifestyle factors include avoiding tobacco, maintaining a healthy weight, eating a heart-healthy diet, limiting alcohol and staying physically active
Heart failure is a serious chronic disease. The rate of death five years after diagnosis is 50 percent in men and 46 percent in women.
Fall Prevention: Out with the Old Shoes, Old Habits
ROCHESTER, Minn. — The right choice of indoor and outdoor shoes can help keep older adults on their feet, according to the June issue of Mayo Clinic Health Letter. Surveys show that old shoes and old habits can contribute to falls in older adults.
Older adults who wear athletic shoes around the house are much less likely to fall than those who go barefoot, wear socks alone or wear slippers. Outside of the home, older adults often opt for slip-on shoes without snug fasteners or laces. Lace-up or strap-on shoes with a snug fit offer the most support.
Surveys have shown that older adults often wear shoes that are worn out and have lost their cushioning or even have flopping parts. Or, some people persist in wearing shoes that are too small or narrow. Feet tend to elongate with age, and a bigger shoe size may be necessary. Poor-fitting or worn-out shoes increase the risk of falls and can contribute to foot problems such as bunions, corns, or pain under the base of the toe joints (metatarsalgia).
Older adults have many shoe choices, including the traditional rocker bottom shoes with a mostly flat sole and upward curve at the toes. There are many newer trends, including double rocker bottom shoes, foot gloves and shoes with negative heels.
Double rocker bottom shoes feature a sole that curves up at the toes and the heel. The sole looks like the bottom of a rocking chair. They can be effective for people with a fused ankle joint or advanced arthritis of the foot or ankle. Mayo Clinic doctors urge caution with this choice, as they require a level of balance that many older adults don’t have, increasing the risk of falling.
Foot gloves fit the foot like a glove and imitate aspects of going barefoot, but with protection from stepping on sharp objects. Originally designed for runners, they are increasingly popular for casual or around-the-house wear. Again, Mayo Clinic doctors urge caution for older adults. Natural foot cushioning diminishes with age, and it’s possible these products could raise the risk of injury in older adults.
Negative heels feature a heel lower than the toe box. For most people, this shoe design stretches the Achilles tendon more than normal with every step, potentially leading to discomfort and injury. Mayo Clinic doctors say the risk of injury from a negative heel shoe outweighs any potential benefits.
Good shoes that fit well aren’t the only factor in preventing falls, but selecting the right footwear can make a difference.
Healthy and Delicious Eating Beyond Meat and Potatoes
ROCHESTER, Minn. — Fruits, vegetables, whole grains and low-fat dairy should be the star attractions of a healthy diet, with only cameo appearances by meat. A special section in the June issue of Mayo Clinic Health Letter, called “Beyond Meat and Potatoes, The Art of Eating Well,” offers ideas and recipes for an appealing, nourishing diet.
Here are some healthy eating tidbits from the Special Report:
Be a new omnivore: No need to swear off meat altogether. But because of the health risks associated with higher cholesterol and saturated fat, it’s best to limit meat consumption to less than six ounces a day.
Don’t forget the fiber: Dietary fiber, also known as roughage or bulk, includes all parts of plant food that the body can’t digest or absorb. It passes through the digestive tract relatively intact. So why bother? Because fiber aids bowel function (and reduces the risk of hemorrhoids), lowers cholesterol levels, helps regulate blood sugar levels, and helps with weight loss. High-fiber foods generally require more chewing time, giving the body time to register that it’s full.
Savory not salty: Limiting salt can help keep blood pressure under control, which may reduce the risk of heart disease, stroke, congestive heart failure and kidney problems. Instead of reaching for the salt, consider adding dried or chopped fresh herbs to soup, salads or sandwich fillings. Flavor boosters such as garlic, fresh ginger, citrus zest and juices or flavored vinegars can lift foods from flat to interesting.
Pounds and calories: It takes about 3,500 calories above a person’s daily calorie needs to gain a pound of body fat. Likewise, it takes about 3,500 calories under the daily needs to lose a pound of body fat. But a few calories more or less every day start to add up. A person who eats just 100 extra calories a day can gain 10 pounds in one year. Conversely, by eating 100 fewer calories a day, a person can lose 10 pounds in one year.
What’s for dinner? The Special Section features 10 easy-to-prepare recipes that go beyond meat and potatoes. Options include broiled trout with tomato and red onion relish, sugar snap peas with fresh marjoram, spicy beef kabobs, grilled pineapple and fresh mixed berries with ginger sauce.
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