DIET AND NUTRITION FOR PEOPLE WITH CHF

Diet and Nutrition for People with CHF

Diet and Nutrition for People with CHF

Introduction

The inability of the heart to expel sufficient blood to keep pace with the metabolic demands of the body. In the healthy individual the heart can tolerate large increases of workload for a considerable length of time. Cardiac failure results from conditions, e.g., coronary artery disease, hypertensive heart disease, valvular insufficiency, and rheumatic heart disease that interfere with the nutrition and oxygenation of the heart muscle itself.

Overview of the Health Issue with Supporting Literature

Congestive heart failure develops in 50% to 60% of patients with such disorders, and it can be either acute or chronic. If the heart has time to compensate, the heart muscle may become hypertrophic (enlarged); this is caused by structural changes that impede blood flow and impair the ability of the heart to relax. Eventually the great demand for oxygen by the heart muscle cells cannot be met, and cell death results. Either the left or right ventricle alone may fail first, although combined failure is most common and almost always eventually occurs. Left ventricular failure is marked by shortness of breath (dyspnea), often accompanied by cough; pulmonary congestion and edema are evident (The Columbia Encyclopedia 2000).

Failure of the right ventricle produces systemic edema, reflecting hepatic and visceral engorgement. Diagnosis is often confirmed by echocardiography. Treatment of cardiac failure usually includes dietary changes, restrictions on physical activity, rest, oxygenation, measures to improve myocardial contractility, and correction of arrhythmias. Restriction on sodium intake and the administration of diuretics (the dosages of which depend on the patient's weight) are used to remove excess sodium and water from the body. Digitalis is often prescribed to increase the speed and force of cardiac contractions, and ACE inhibitors are used to decrease peripheral vascular resistance, making heart pumping easier and more effective.

Congestive heart failure (CHF) is one of the major causes of illness and disability in the United States and is the leading cause of hospitalization in people older than 65, according to the 1999 Harvard Medical School Family Health Guide. The condition afflicts nearly 5 million Americans, and the numbers are increasing, especially among the elderly.

Between 1979 and 1998, the number of deaths from heart failure more than doubled, from 25,074 to 50,228, according to the National Center for Health Statistics. Of those, deaths from CHF climbed from fewer than 20,000 to nearly 47,000.

Project Selection and Criteria

While nearly 900,000 Americans died from heart disease or stroke in 2000, according to the National Center for Health Statistics, almost 62 million Americans--about one in five--is living with the often debilitating consequences of these diseases. The population is aging, so as we get better at treating heart attacks and have survival at younger ages; a large number of Americans are living with damaged hearts that incrementally lose effectiveness as the person gets along in years.

CHF can be caused by prolonged high blood pressure; atherosclerosis, or a narrowing of blood vessels from ...