Heart failure is an irreversible disease. As long as the heart function is damaged, it cannot restore its original function. Only drugs can improve symptoms and slow down deterioration. Therefore, early diagnosis and treatment, and taking drugs on time are very important. Heart failure drugs can reduce the load on the heart, Improve the structure of the heart and allow patients to regain a healthy and normal life.
This article explains the three major symptoms of heart failure, helps you detect possible conditions early, and explains the treatment strategies for heart failure and the most common clinical comorbidities. Together, we can protect your “heart”, improve your quality of life, and live longer. Healthier, longer.
Heart failure is the final stage in the evolution of all cardiovascular diseases and has a high mortality rate. A heart failure patient who had been taking medication for many years gradually returned to a normal life after his condition stabilized. His daily travels and exercises were no different from those of ordinary people. However, after he tried to reduce his medication on his own, symptoms that had not been seen for many years reappeared. Doctors explained that to control heart failure, early diagnosis and early treatment, taking medication regularly and maintaining a stable dose are the only ways.
This article explains why heart failure is irreversible and the importance of early treatment. It also introduces the first-line treatment drugs for heart failure, as well as two major treatment points that most people are unaware of.
Heart failure has a high mortality rate, and early treatment improves prognosis and survival rate
Heart failure, also known as congestive heart failure, is commonly known as “heart weakness”. It means that due to impaired heart function, it is unable to pump out sufficient blood volume to meet the metabolic needs of the body and tissues, resulting in a series of symptoms. Patients with heart failure often not only have heart problems, but also often suffer from other comorbidities, among which coronary artery disease, hypertension, and diabetes are the most common. (Extended reading: Kidney dialysis patients are 10 times more likely to suffer from heart failure than ordinary people. Detailed explanation of the types, risks, and treatment of cardiorenal syndrome)
Heart failure will cause the body to secrete neurohormones, stimulate sympathetic nerve hyperactivity and other factors, causing myocardial cell apoptosis or death, which will further damage the heart function and form a vicious cycle. However, although drugs can improve the symptoms of heart failure, the damaged Heart function cannot be restored, so the focus of treatment is early diagnosis and early treatment to avoid further deterioration of heart function.
There are two main heart failure classification systems, one is the New York Heart Association’s symptom classification, and the other is the American Heart Association’s comprehensive classification that takes into account heart failure risk factors. Director Zeng Bingxian emphasized that no matter which classification it is, early treatment has better effects. The earlier the treatment, the better the patient’s prognosis, mortality and survival rate can be improved.
According to the American Heart Association’s ABCD classification, the 5-year survival rate is 97% for both grades A and B, but for grade C, the 5-year survival rate drops to 74%, and for grade D, it is only 20%. It can be seen that early treatment can importance in improving survival rates.
Heart failure requires regular medication. Reducing or stopping medication at will can easily worsen the condition.Introduction to 4 major categories of drugs for first-line treatment of heart failure
There are currently 4 major categories of drugs as first-line treatments for heart failure:
- Collectively referred to as Class A drugs: they can dilate blood vessels, lower blood pressure, reduce cardiac load, and inhibit the renin-angiotocin system.
- Angiotensin-converting enzyme inhibitor (ACEI)
- Angiotensin receptor blockers (ARBs)
- New dual-mechanism drug improves heart function.
- Angiotensin-converting enzyme inhibitor (ACEI)
- Beta-blockers (β-blockers): can slow down the heartbeat, lower blood pressure, and inhibit the sympathetic nervous system.
- Mineral corticoid/aldosterone receptor blockers (MRA): Promote the elimination of sodium and water by the kidneys and reduce the cardiovascular harm of hormones.
- Sodium glucose transporter type 2 inhibitor (SGLT2i): Promotes the kidneys to eliminate sugar, thereby eliminating body water, and promotes heart function by participating in lipid and other mechanisms.
Basically, the focus of the four major categories of drugs is to reduce cardiac load and prevent myocardial cells from being continuously stimulated by adverse hormones and sympathetic nerves. According to European and American clinical guidelines, if heart failure is diagnosed and symptoms are already present, it is recommended to use the above four major categories of drugs directly. ; Because heart failure is a serious condition, patients should actively receive treatment to control the condition.
Heart failure requires regular medication. Reducing or stopping medication at will can easily worsen the condition.
The treatment of heart failure has two focuses:
- Attempts should be made to adjust the medication to the target dose.
- Once the patient’s condition is stable, easily reducing or stopping the medication can easily worsen the condition.
After clinical trials of heart failure drugs, the target dose required to achieve the best efficacy will be determined; doctors will slowly increase the dose depending on the patient’s condition in order to control the condition as soon as possible; if the patient develops hypotension while taking the medication , hyperkalemia or other problems, the doctor will temporarily lower the dose, and then try to increase it after the situation stabilizes; generally speaking, doctors will work with patients to work towards the target dose. As long as the dose can reach more than 50%, the curative effect will be will be significantly improved; however, some patients may take half a year or more than a year to reach the target dose due to unstable physical conditions.
When the patient has received drug treatment, the dosage or efficacy can only be increased, and should not be lowered at will unless there are other conditions. Director Zeng Bingxian explained that the well-known symptoms such as fatigue, breathlessness, and swelling are just the tip of the iceberg of heart failure. Even if the symptoms stabilize after taking medication, the heart may continue to be damaged and worsened, so it is necessary to continue to take medication stably to properly control it. ; Any reduction or discontinuation of medication, or switching to a less effective medication may aggravate the condition.