- ALLERGY, RESPIRATORY
- Childhood Food Allergies on the Rise
- Keep Asthma, Allergies at Bay for the Holidays
- Molecule in Skin May Link Eczema and Asthma
- ALTERNATIVE MEDICINE
- Ginger Can Ease Nausea From Chemotherapy Treatments
- Music Therapy For Prehistoric Man?
- Holistic Treatment for Candida Infection
- ANIMAL CARE
- Beware of Dog Bites
- Animals Respond to Acupuncture's Healing Touch
- Separation Anxiety, Canine-Style
- BONES & JOINTS
- Most Kids With Type 1 Diabetes Lack Vitamin D
- A Winning Strategy to Beat Spring Sporting Injuries
- Fruits and Veggies May Strengthen Bones
- CANCER
- Vitamin D May Improve Melanoma Survival
- Minorities Distrust Medical System More
- Many Cancer Patients Turn to Complementary Medicine
- CAREGIVING
- MRSA Infections Spreading to Kids in Community
- Transition From Home to Hospital Rarely Seamless
- Children's Bath Products Contain Contaminants
- CIRCULATORY SYSTEM
- Secondhand Smoke Quickly Affects Blood Vessels
- Health Tip: Are You Anemic?
- Years of Exposure to Traffic Pollution Raises Blood Pressure
- COSMETIC
- Get Sugared!.... Its a sweet choice for hair removal
- Gum Chewing May Cut Craving for Snacks
- The Acne Drug Accutane More Than Doubles Depression Risk
- DENTAL, ORAL
- Toothbrushing May Stave Off Heart Woes
- Health Tip: At Risk for Gingivitis
- An Oral Approach to Heart Disease
- DIABETES
- 'Standard' Glucose Test May Be Wrong One for Obese Children
- Patients' Photos Help Boost Radiologists' Accuracy
- Out-of-Control Blood Sugar May Affect Memory
- DIET, NUTRITION
- HELP TO LOSE WEIGHT ON A LOW CAL BUDGET
- Diet, Exercise May Slow Kidney Disease Progression
- Coffee Drinkers Might Live Longer
- DISABILITIES
- Review Finds Marijuana May Help MS Patients
- Could Your Cell Phone Help Shield You From Alzheimer's?
- ENVIRONMENTAL HEALTH
- Freckles, Moles May Indicate Risk for Eye Cancer
- Pregnant Rural Women More at Risk
- Ozone Pollution Taking Toll on American Lives
- EYE CARE, VISION
- Vision Test for Young Children Called Unreliable
- Eye Care Checkups Tied to Insurance Status
- 'Blind' Man Navigates Obstacle Course Without Error
- FITNESS
- Living With Less TV, More Sweat Boosts Weight Loss
- Avoiding a Holiday Season of Discontent
- Weak Muscles May Cause 'Runner's Knee'
- GASTROINTESTINAL PROBLEMS
- Traditional Nonsurgical GERD Treatments Not Impressive
- Japanese Herbals May Ease Gastro Woes
- Gum Chewing May Speed Colon Surgery Recovery
- GENERAL HEALTH
- Keep Fire Safety in Mind as You Celebrate
- U.S. Prepares for Possible Return of Swine Flu in Fall
- Study Supports Swine Flu's Pandemic Potential
- HEAD & NECK
- Zen May Thicken Brain, Thwart Pain
- Ski Helmets Encouraged for All
- Many Children Will Outgrow Headaches
- HEALTH & TECHNOLOGY
- Subway Defibrillators Save Lives
- 'Comfort Dogs' Come to Emotional Rescue
- Airport Full Body Scanners Pose No Health Threat: Experts
- HEART & CARDIOVASCULAR
- Vitamin B3 May Help Repair Brain After a Stroke
- Polyunsaturated Fats Really May Lower Heart Risk
- Western Diet Linked To Heart Disease, Metabolic Syndrome
- INFECTIOUS DISEASE
- Swine Flu Closes Three Schools in NYC
- Grapefruit Compound Inhibits Hepatitis C Virus
- Poor Restroom Cleaning Causes Cruise-Ship Sickness
- KID'S HEALTH
- Coconut Oil May Help Fight Childhood Pneumonia
- Teen Internet Addicts More Likely to Self-Harm: Study
- Too Many Infants Short on Vitamin D
- MEN'S HEALTH
- Vigorous Exercise Cuts Stroke Risk for Men, Not Women
- Physical Activity May Prolong Survival After Colon Cancer
- Exercise May Prevent Prostate Cancer: Study Shows
- MENTAL HEALTH
- Green Spaces Boost the Body and the Mind
- Shop 'Til You Drop: You May Feel Better
- Estrogen May Help Men's Hearts
- PREGNANCY
- Prenatal Stress May Boost Baby's Asthma Risk
- Breast-Feeding May Protect a Woman's Heart
- Placebo Acupuncture Tied to Higher IVF Pregnancies
- SENIORS
- The Healthy Habits of Centenarians
- Mediterranean Diet Plus Exercise Lowers Alzheimer's Risk
- Living Alone Increases Odds of Developing Dementia
New Guidelines for Treating Heart Failure
By eHolistic.com Published: 03/26/2009
THURSDAY, March 26 (HealthDay News) -- New guidelines for treatment of heart failure are being issued by the American Heart Association and the American College of Cardiology, with a strong emphasis on management of people hospitalized for the condition and also on the treatment of blacks.
"The most important change is the addition of a new section on hospitalized patients," said Dr. Mariell Jessup, professor of medicine at the University of Pennsylvania and chairwoman of the guidelines writing group. "It's unusual to have a completely new section, but it is increasingly recognized that hospitalization for heart failure contributes substantially to morbidity and mortality and to health-care costs."
About 5.7 million Americans have heart failure, the progressive loss of ability to pump blood, and 1.1 million people are hospitalized because of it each year. Heart failure management will cost the U.S. health-care system more than $37 billion this year, the guidelines group estimated.
Guidelines are assessed periodically to determine whether results of new trials or studies require changes, Jessup said. "We found that enough has happened for the guidelines to be changed," she said. "The most important studies were on hospitalized patients, so we felt there was a gap we had to fill."
The guidelines are being published in the Journal of the American College of Cardiology and in the Heart Association journal Circulation
The new guidelines "outline what has to happen in the initial evaluation, such as measurement of ejection fraction and whether the patient has coronary disease or not," Jessup said. "They describe what should be done each day to assess the patient and the need to think carefully about which drugs should be given and why."
Drug assessment includes "the role of cardioactive drugs including nitroglycerine," Jessup said. "The guidelines also stress the role of evidence-based medicine and also what should be considered in the discharge of a patient from the hospital."
Special consideration is given to blacks, she said, because "heart failure has a different etiology [cause] and tends to occur younger" in blacks than in others. The guidelines stress the use of two drugs, hydralazine and isosorbide dinitrate, in blacks. Both relieve pressure on the heart by relaxing blood vessels.
"A trial showed that using them in a fixed-dose combination produced a remarkable reduction in mortality in African-Americans, and we really wanted to strengthen the recommendations that they should be used in African-Americans," Jessup said.
The drugs are effective, because heart failure in blacks has been shown to be more related to high blood pressure than it is in whites, she said. "Also, African-Americans with heart failure don't seem to have as much coronary disease," or blockage of the heart arteries, Jessup said.
One revised section of the guidelines contains simplified advice on implantable cardioverter defibrillators, which can prevent sudden cardiac death by delivering a shock to restore normal heart rhythm when the heart suddenly beats irregularly. Various guidelines on the use of these devices have been issued, Jessup said, "and we are trying to simplify what we have said about them," Jessup said.
Also revised is the guideline section on treatment of people who have both heart failure and the arrhythmia called atrial fibrillation. There has been a debate about whether it is better to center treatment on relieving heart failure or on restoring normal heart rhythm, Jessup said. Several studies have shown that neither strategy is superior, and so the guidelines say a decision should be based on individual patient characteristics, she said.
-Ed Edelson
More information
The American Heart Association has more on heart failure.
SOURCES: Mariell Jessup, M.D., professor of medicine, University of Pennsylvania School of Medicine, Philadelphia; March 26, 2009, Circulation; March 26, 2009, Journal of the American College of Cardiology
Last Updated: March 26, 2009
Copyright © 2009 ScoutNews, LLC. All rights reserved.
More articles at www.eholistic.com
