Congestive Heart Failure Survival:

Proper Treatment Provides Improvements

Congestive Heart failure Survival On The Rise

Congestive heart failure survival becomes an important issue in light of statistics like this…

There will be approximately 400,000 new cases of CHF diagnosed in the U.S. this year.

In fact CHF is the leading cause of hospitalization for people over 65. The Framingham study demonstrated that 30% of CHF patients died within one year of diagnosis and 60% died within the first five years.

The Framingham study is an ongoing epidemiologic study involving more than 5,000 people among the population of Framingham, MA. It has been conducted since 1949 by the National Institutes of Health and Boston University.

The study has also demonstrated that congestive heart failure survival rates remained unchanged from the 1950s through the 1980s. With such statistics one might wonder if there is any good news in relation to CHF.

As our population ages and more people are living longer we might expect an increase in death from CHF. However this expectation has been somewhat altered. In the 1990s short-term mortality rates showed a 25% decline. Long-term mortality rates were reduced by 50%.

Why The Improvement?

This alteration was supported by an article in the New England Journal of Medicine reporting that long-term trends in the incidence and survival of CHF show some improvement. An editorial by Margaret Redfield, M.D., of the Mayo Clinic, places the credit for these improvements on the shoulders of medications such as…

  • beta-blockers
  • ACE inhibitors
  • aldosterone antagonists

Beta-blockers compose a large group of medications that act to block specific receptors in the nervous system. The results include…

  • slowing heart rate
  • lowering blood pressure
  • reducing anxiety

Beta-blockers have been successfully used to treat…

  • angina
  • arrhythmias
  • hypertension
  • mitral valve prolapse
ACE inhibitors

 are used to reduce blood pressure by inhibiting angiotensin-converting enzyme. (It is a compound involved in processes that result in the increased contraction of the vascular smooth muscle. Ultimately it raises blood pressure.) Studies have also indicated that ACE inhibitors may prevent the progression of kidney disease in diabetes patients. 

Aldosterone antagonists are compounds that inhibit the biosynthesis of aldosterone - a steroid hormone produced by the adrenal cortex. It controls salt and water balance in the kidneys. Elevated levels of aldosterone cause…

  • sodium retention
  • hypertension
  • arrhythmias

CHF is the resulting condition of these pre-mentioned maladies. Since the medications described here reduce the incidence and severity of cardiac damage they have been implicated in improving congestive heart failure survival.

In spite of the good news referenced above the fact is the senior population is expected to double over the next forty years. Trends being what they are there is every expectation that there will be a corresponding increase in CHF and congestive heart failure survival will be an increasingly important topic. If we hope to see this trend turn downward…

More attention will need to be focused on the prevention, early detection and early treatment of the underlying causes of congestive heart failure.

To support this let’s look at a couple of studies involving conventional and natural treatments in relation to congestive heart failure survival.


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Are there health issues – in addition to your heart health – that concern you? Like…

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  • And poor nutrition?
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Conventional Treatments for CHF

With congestive heart failure the heart is often weak while forced to supply a body with a less than desirable vascular system. While the arteries are getting progressively clogged the heart, weakened perhaps by other conditions, is overworked pushing blood through congested channels. 

This situation, and other similar scenarios, makes blood vessel dilators a popular choice in CHF treatment. ACE inhibitors, described above, are among the most prescribed blood vessel dilators in the treatment of this varied condition. That is because…

Increases in congestive heart failure survival rates are higher with ACE inhibitors than with other vasodilators.

For example, the ACE inhibitor enalapril maleate has been demonstrated to reduce mortality rates due to CHF. Enalapril…

  • controls essential and renal (pertaining to the kidneys) hypertension
  • improves kidney filtration
  • improves blood flow
  • reduces resistance of the vascular system

In the Cooperative North Scandinavian Enalapril Survival Study, enalapril was tested on patients already receiving digoxin and diuretics. In addition to the drugs already in use, some of the patients received enalapril while others received a placebo.

The patients receiving enalapril demonstrated an improved congestive heart failure survival rate as well as improvement in quality of life.

In the second Veterans Affairs Cooperative Vasodilator-Heart Failure Trial enalapril was compared to other vasodilators. In the study involving 804 patients a combination of isosorbide dinitrate and hydralazine was given to a randomly chosen subset of the population. The rest received enalapril.

Isosorbide dinitrate is a vasodilator used in the treatment of angina. It is similar to nitroglycerin but with a slower onset of action. Hydralazine is a peripheral vasodilator used to reduce blood pressure.

The congestive heart failure survival rates were significantly higher with the enalapril group. Similar findings in other studies have made ACE inhibitors the choice medication for patients with CHF. Because CHF is usually a multifaceted problem it is often treated with a combination of therapies. Treatments may include…

  • diuretics - agents that promote urine excretion through their effects on kidney function
  • digoxin - used to control ventricular rate in atrial fibrillation
  • vasodilators such as ACE inhibitors.

Inotropic agents - compounds that improve the force of muscular contractions - are also used to relieve symptoms but have not shown the survival rate advantage of ACE inhibitors. 

See More on Conventional CHF Treatments.

Non-Conventional Treatments for CHF

Treatments affecting congestive heart failure survival are not limited to conventional medicine. Lifestyle modifications help control CHF symptoms and prolong life. Smoking cessation and dietary considerations should not be overlooked. The decline in heart health in much of the developed world is linked to lifestyle changes. 

Beyond this there are natural substances shown to dramatically relieve CHF symptoms and improve survival. One of the most studied of these is Coenzyme Q10 (CoQ10)

One study (by Langsioen) including 126 patients (ages 19-80) involved supplementing 100 mg of CoQ10 daily in three equal dosages. The treatment was sustained for six years while conventional CHF therapy was continued. Periodic assessments evaluated ejection fraction (measure of ventricular contractility), blood levels of CoQ10 and congestive heart failure survival.

Average ejection fractions improved from 41% to 59% within six months and remained stable throughout the study period.

CoQ10 blood levels increased from 0.85 µg/mL to 2 µg/mL in three months. Congestive heart failure survival was also improved. Many of the patients no longer had symptoms of CHF. 

CoQ10, like many conventional drugs, increases heart output by strengthening muscular contractions. The increased contractibility requires higher levels of ATP, or adenosine triphosphate, (a nucleotide present in all living cells which serves as an energy source for many metabolic processes). Without ATP the body cannot function. 

CoQ10 is essential for the production of ATP and is produced by the body to a lesser degree as we age. CoQ10 supplementation has an advantage over conventional treatments in that, while increasing muscular contractibility…

It also produces the ATP necessary for the production of cellular energy.

In fact beta-blockers have been shown to decrease blood CoQ10 levels by inhibiting CoQ10-dependent enzymes. Therefore it is often recommended that a patient using beta-blockers should also supplement with CoQ10 to replenish a supply that, not only dwindles with age, but is also reduced by medications. 

One main factor that decreases congestive heart failure survival is high blood pressure. Studies have been conducted to demonstrate the relationship between CoQ10 deficiencies and hypertension. CoQ10 supplementation has shown benefits for patients who were treated simultaneously with antihypertensive drugs as well as for those patients receiving no conventional treatments.

In the majority of cases significant improvements have been reported for both groups in systolic and diastolic pressure. Greenberg specifically noted considerable improvement for patients receiving 100 mg of CoQ10 per day.

Another study including 109 patients with hypertension attempted to maintain CoQ10 blood levels at or exceeding 2.0 µg/mL while continuing conventional treatments. The average daily supplementation level was about 225 mg.

Improvements were observed within the first six months allowing many of the patients to reduce their antihypertensive drug intake. In fact, 51% of the patients were able to use at least one, and up to three, fewer drugs.

One further example can be seen in an uncontrolled study involving 26 patients with essential hypertension (hypertension without known cause). Each participant received two 50 mg doses of CoQ10 per day after discontinuing all antihypertensive medicines.

After ten weeks diastolic and systolic pressure readings were significantly improved and serum CoQ10 levels were increased.

A further bonus included the reduction of total serum cholesterol and an increase of HDL cholesterol. 

Though natural treatments like CoQ10 have direct impact on congestive heart failure survival for patients with CHF symptoms they are perhaps even more beneficial as prevention measures. CoQ10 has its greatest impact on CHF which is less severe than more advanced cases when much cardiac damage has occurred. 

This would lead some to believe that CoQ10 provides its greatest benefit before symptoms of damage appear. Since CoQ10 is essential for the production of ATP, preventive supplementation could keep CHF symptoms, and the underlying cardiac damage, from beginning. 

See More on Natural CHF Treatments. 

Return from Congestive Heart Failure Survival to CHF Main Page.

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