ALLERGY, RESPIRATORY
Asthmatics Who Quit Smoking May Reverse Lung Damage
Air Pollution May Raise Blood Pressure
Keep Asthma, Allergies at Bay for the Holidays
ALTERNATIVE MEDICINE
Acupuncture May Trigger Natural Painkiller
Memory Loss Help from Brain Supplement Prevagen
Naprapathy: A Hands-On Approach to Pain Management
ANIMAL CARE
Separation Anxiety, Canine-Style
Animals Respond to Acupuncture's Healing Touch
'Comfort Dogs' Come to Emotional Rescue
BONES & JOINTS
Scientists Discover How Osteoarthritis Destroys Cartilage
Bone Density Predicts Chances of Breast Cancer
More Faces Being Spared in Motor Vehicle Accidents
CANCER
Immune Therapy May Aid Kids With Neuroblastoma
Well Water Might Raise Bladder Cancer Risk
Occaisonal Dieting May Cut Breast Cancer, Study Says
CAREGIVING
Child's Food Allergies Take Toll on Family Plans
Undoing the 'Big Baby' Trend
3 Steps Might Help Stop MRSA's Spread
CIRCULATORY SYSTEM
A Brisk Pace May Keep Stroke at Bay
Vitamins Do Older Women Little Good
Exercise Extends Life of Kidney Patients
COSMETIC
The Acne Drug Accutane More Than Doubles Depression Risk
Science May Banish Bad Hair Days
Gum Chewing May Cut Craving for Snacks
DENTAL, ORAL
Most Insured Adults Worry About Health Care Costs: Poll
Biological Product Shows Promise Against Gum Disease
Study Links Osteoporosis Drugs to Jaw Trouble
DIABETES
Exercise Protects Black Women From Type 2 Diabetes
Findings Challenge Tight Glucose Control for Critically Ill Patients
Poor Blood Sugar Control After Heart Surgery Impacts Outcomes
DIET, NUTRITION
The 3LS Wellness Program for Reversing Chronic Symptoms and Creating Lasting Health
Purple Tomato Extended Lives of Cancer-Prone Mice
Fasting on Alternate Days May Make Dieting Easier
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Arsenic in Drinking Water Raises Diabetes Risk
Cleaning House May Be Risky for Women With Asthma
Bed Bugs Bring No Disease Danger
EYE CARE, VISION
High Temps Degrade Contact Lens Solution: Study
Brain Pressure More Likely to Cause Vision Loss in Men
Action-Filled Video Games Boost Adult Vision
FITNESS
As Temperature Plummets, It's Still Safe to Exercise
Many Cancer Survivors Don't Adopt Healthy Lifestyle
Seniors Who Exercise Help Their Health
GASTROINTESTINAL PROBLEMS
Soothing Imagery May Help Rid Some Kids of Stomach Pain
Bowel Prep Harder on Women Than Men
Intestinal Bacteria Trigger Immune Response
GENERAL HEALTH
Want Better Health in the New Year, Add Exercise to Your Day
What you need to know about swine flu.
A Honey of a Sinusitis Treatment
HEAD & NECK
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
HEALTH & TECHNOLOGY
Subway Defibrillators Save Lives
Using Light Therapy to Silence Harmful Brain Activity
Study Suggests Link Between Cell Phones and Brain Tumors
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
More Steps a Day Lead to Better Health
Brown Rice Tied to Better Heart Health in Study
Small Cuts in Salt Intake Spur Big Drops in Heart Trouble
INFECTIOUS DISEASE
Poor Restroom Cleaning Causes Cruise-Ship Sickness
Surgical Masks Could Prevent Flu, Maybe
The HPV Vaccine: Preventative Medicine or Human Sacrifice?
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Family Medicine Cabinet Top Source Of Kid's Poisonings
Teen Stress May Have Roots in First Three Years of Life
Don't Leave Your Kids In The Car !
MEN'S HEALTH
Lots of Sex May Prevent Erectile Dysfunction
Sunlight May Help Protect Men From Kidney Cancer
Countdown to Hair Loss
MENTAL HEALTH
Music Soothes Anxiety as Well as Massage Does
Have a Goal in Life? You Might Live Longer
Man's Best Friend Helps Mend Broken Hearts
PAIN
Tai Chi May Help Ease Fibromyalgia
Alleviating Rheumatoid Arthritis
'Cell Phone Elbow' -- A New Ill for the Wired Age
PHYSICAL THERAPY
PREGNANCY
Heart Defects in Newborns Linked to Antidepressants
Before Conceiving, Take Folic Acid for One Full Year
Exercise As Well As Acupuncture, May Ease Polycystic Ovarian Syndrome
SENIORS
Older People at Greater Risk of Swine Flu Death
More Whole Grains May Mean Less Fat
For Older Walkers, Faster Is Better
SEXUAL HEALTH
SLEEP DISORDERS
Daylight Savings: Not a Bright Time for All
Pay Attention to Signs That Say You're Too Fatigued to Drive
Meditation May Help Put Primary Insomnia to Bed
WOMEN'S HEALTH
How Much Fish to Eat While Pregnant?
Pre-Pregnancy Weight Linked to Babies' Heart Problems
Health Tip: Be More Comfortable During Childbirth
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New Guidelines for Treating Heart Failure

THURSDAY, March 26 (HealthDay News) -- New guidelines for treatment of heart failure are being issued by the American Heart Association and the American College of Cardiology, with a strong emphasis on management of people hospitalized for the condition and also on the treatment of blacks.

"The most important change is the addition of a new section on hospitalized patients," said Dr. Mariell Jessup, professor of medicine at the University of Pennsylvania and chairwoman of the guidelines writing group. "It's unusual to have a completely new section, but it is increasingly recognized that hospitalization for heart failure contributes substantially to morbidity and mortality and to health-care costs."

About 5.7 million Americans have heart failure, the progressive loss of ability to pump blood, and 1.1 million people are hospitalized because of it each year. Heart failure management will cost the U.S. health-care system more than $37 billion this year, the guidelines group estimated.

Guidelines are assessed periodically to determine whether results of new trials or studies require changes, Jessup said. "We found that enough has happened for the guidelines to be changed," she said. "The most important studies were on hospitalized patients, so we felt there was a gap we had to fill."

The guidelines are being published in the Journal of the American College of Cardiology and in the Heart Association journal Circulation

The new guidelines "outline what has to happen in the initial evaluation, such as measurement of ejection fraction and whether the patient has coronary disease or not," Jessup said. "They describe what should be done each day to assess the patient and the need to think carefully about which drugs should be given and why."

Drug assessment includes "the role of cardioactive drugs including nitroglycerine," Jessup said. "The guidelines also stress the role of evidence-based medicine and also what should be considered in the discharge of a patient from the hospital."

Special consideration is given to blacks, she said, because "heart failure has a different etiology [cause] and tends to occur younger" in blacks than in others. The guidelines stress the use of two drugs, hydralazine and isosorbide dinitrate, in blacks. Both relieve pressure on the heart by relaxing blood vessels.

"A trial showed that using them in a fixed-dose combination produced a remarkable reduction in mortality in African-Americans, and we really wanted to strengthen the recommendations that they should be used in African-Americans," Jessup said.

The drugs are effective, because heart failure in blacks has been shown to be more related to high blood pressure than it is in whites, she said. "Also, African-Americans with heart failure don't seem to have as much coronary disease," or blockage of the heart arteries, Jessup said.

One revised section of the guidelines contains simplified advice on implantable cardioverter defibrillators, which can prevent sudden cardiac death by delivering a shock to restore normal heart rhythm when the heart suddenly beats irregularly. Various guidelines on the use of these devices have been issued, Jessup said, "and we are trying to simplify what we have said about them," Jessup said.

Also revised is the guideline section on treatment of people who have both heart failure and the arrhythmia called atrial fibrillation. There has been a debate about whether it is better to center treatment on relieving heart failure or on restoring normal heart rhythm, Jessup said. Several studies have shown that neither strategy is superior, and so the guidelines say a decision should be based on individual patient characteristics, she said.

-Ed Edelson

More information

The American Heart Association has more on heart failure.



SOURCES: Mariell Jessup, M.D., professor of medicine, University of Pennsylvania School of Medicine, Philadelphia; March 26, 2009, Circulation; March 26, 2009, Journal of the American College of Cardiology

Last Updated: March 26, 2009

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