After Steady Decline, Heart Failure Deaths Up, CDC Says

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For more than a decade, deaths from heart failure were steadily declining. But that's no longer the case. According to a new report from the Centers for Disease Control and Prevention, from 2012-2014 there was a slight but steady climb in the number of deaths in this category.

Other key findings in the report show that the death rate was higher for blacks, than for whites or Hispanics. Men have higher heart-failure-related deaths than women in all age groups. The fraction of heart failure (HF) patients who died in a hospital actually decreased from 32 percent in 2000, to 23 percent in 2014. Additionally, HF caused by coronary heart disease (CHD) as an underlying cause has decreased, meaning that other diseases are responsible for HF (i.e. cancer, diabetes, chronic lower respiratory diseases and kidney disease).

The underlying cause of heart-failure-related deaths ¦ was less likely to be CHD and more likely to be other cardiovascular diseases and noncardiovascular diseases, said lead investigator, Dr. Hanyu Ni of the CDC s National Center for Health Statistics (NCHS) via Medscape. This shift in distribution of causes of death toward less ischemic heart disease ¦ is important for heart-failure management approaches.

The reason this is important is because not all heart failure is the same. There are two main types: left-sided, in which fluid overload occurs in the lungs, and right-sided, in which edema of the legs predominates.

Each of these general types has multiple different etiologies. The most common heart failure, left-sided, is primarily caused by long-standing high blood pressure, or CHD.

Unlike most other muscles in the body, bigger does not mean better when it comes to the heart. An enlarged heart is a dysfunctional heart, inefficient at doing what it is supposed to effectively pumping blood through the body.

Knowing the underlying cause allows tailoring of treatment. Click on this link for different causes of worsening heart failure.

The goals of therapy for HF are to improve symptoms, quality of life, functional status, reduce hospitalizations and ultimately reduce rates of HF-related death. Management of the disease will require lifestyle modifications and ensuring that the underlying cause or causes are all adequately treated. These patients will need serial monitoring to ensure the goals of treatment are being optimally met.

Hopefully, by the time the next CDC report is published, the number of HF-related deaths will be headed in the appropriate direction, as it had been for many years prior.