Management of Heart Failure

Abstract

Counseling and education can improve patient outcomes and decrease unnecessary hospitalizations. Patients with mild to moderate heart failure should be restricted to 3 g/d of sodium initially. Those who are unresponsive to this dosage or who have more severe disease should be advised to consume 2 g/d or less. Patients should be strongly advised to drink no more than 30 mL/d of alcohol or, preferably, to abstain completely. Exercise training is safe and can improve exercise duration and symptoms. Adherence to the treatment plan should be stressed and monitored at each visit. Clinicians should inform patients of the seriousness of their disease and their prognosis, but they should emphasize that patients can continue to remain active and enjoy a reasonable quality of life.

Usefulness of a history of tobacco and alcohol use in predicting multiple heart failure readmissions among veterans∗∗The data collection for this study was carried out by the primary investigator at the Greater Los Angeles VA Medical Center while she was employed there as a Research Nurse.

“…12 Likewise, abstention from alcohol is essential in patients with confirmed alcoholic cardiomyopathy. 13 In addition, many clinicians have adopted a conservative approach and recommend complete alcohol abstention in patients with severe HF not related to alcohol, despite equivocal evidence regarding its efficacy in these patients. 14,15 Our finding that compliance to these recommendations is low, with 35.6% of patients with HF continuing to use alcohol, is comparable to other recent studies of up to 40% noncompliance to alcohol abstention.…”

Heart failure in frail, older patients: We can do ‘MORE’

“…Sodium intake should be restricted to less than 3 g/day by not adding salt to meals and by avoiding salt-rich foods (eg, canned and processed foods). 24 During times of distressing volume overload, a tighter sodium limit of 2 g/day is necessary, and diuretics may be less effective if this restriction is not implemented.…”

“…26 Abstinence is a must for patients with alcohol-induced heart failure; otherwise, a limit of 1 drink (8 oz of beer, 4 oz of wine, or 1 oz of hard liquor) per day is suggested. 24 Calories and fat intake are both important to watch, particularly in patients with obesity, hyperlipidemia, hypertension, or coronary artery disease.…”

Physical and psychological impact of yoga therapy in improving heart failure

“…2 Women >80 years of age have a significantly greater prevalence than males of the same age. 3 CCF is responsible for c. 0.5 to 1.8 million admissions annually in India and is one of the leading medical causes of admission at the early age of 53 years, 3 in contrast to USA and Europe where it becomes the leading cause only at 69 years. The mortality of CCF in India is 10% to 30.8% against 4% to 7% in rich countries.…”