ALLERGY, RESPIRATORY
Traffic, Dust Linked to Asthma in Kids
Overweight Moms More Likely to Have Asthmatic Kids
Childhood Food Allergies on the Rise
ALTERNATIVE MEDICINE
Regular Yoga May Improve Eating Habits
Ginkgo No Shield Against Alzheimer's
Naprapathy: A Hands-On Approach to Pain Management
ANIMAL CARE
Safe Toys for Dogs
Separation Anxiety, Canine-Style
Beware of Dog Bites
BONES & JOINTS
Low Vitamin D Raises Women's Hip Fracture Risk
In Elderly Women, Hip Fractures Often Follow Arm Breaks
Study Examines How Rheumatoid Arthritis Destroys Bone
CANCER
Healthy Behaviors Slow Functional Decline After Cancer
Scams and Shams That Prey on Cancer Patients
Minorities Distrust Medical System More
CAREGIVING
Obese Children More Likely to Suffer Lower Body Injuries
Reduce Suffering, Urge Heart Failure Patients and Caregivers
Transition From Home to Hospital Rarely Seamless
CIRCULATORY SYSTEM
Bye, Bye Back Fat?
Smog Tougher on the Obese
Bad Marriages Harder on Women's Health
COSMETIC
Mouse Study Finds Molecule That Tells Hair to Grow
Get Sugared!.... Its a sweet choice for hair removal
Contact Lenses Boost Kids' Self-Image
DENTAL, ORAL
Good Oral Hygiene May Protect Against Heart Infections
Periodontal Disease Impacts Whole Health
Rheumatoid Arthritis May Harm Gums
DIABETES
Vitamin K Slows Insulin Resistance in Older Men
Brown Rice Bests White for Diabetes Prevention
Arthritis Hits More Than Half of Diabetics
DIET, NUTRITION
Myrrh May Lower High Cholesterol
Marinades Help Keep Grilled Meat Safe
Mediterranean Diet Enriched With Nuts Cuts Heart Risks
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Database Helps Assess Your Breast Cancer Risk
Global Warming Linked to Heightened Kidney Stone Risk
Air Quality Better in Northeast, Midwest
EYE CARE, VISION
Statin Drugs Cause Eye Disorders
Antioxidant-Rich Diet May Protect Against Eye Disease
Eye Care Checkups Tied to Insurance Status
FITNESS
Exercise Cuts Lung Cancer Risk in Ex-Smokers by 45%
Barefoot Best for Running?
Will the Wii Keep You Fit?
GASTROINTESTINAL PROBLEMS
New Yogurt May Ease Stomach Ulcers
Traditional Nonsurgical GERD Treatments Not Impressive
Bowel Prep Harder on Women Than Men
GENERAL HEALTH
Kids With Vitamin D Deficiency Linked to Heart Trouble
Surgical Masks Could Prevent Flu, Maybe
Simple Exercise Precautions To Help Keep Baby Boomers Fit
HEAD & NECK
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
Subway Defibrillators Save Lives
Combating Myths About Seasonal Allergies
Imaging Sheds Light on How Acupuncture Works
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Shedding Light on Why Omega-3 Fatty Acids May Help the Heart
Small Cuts in Salt Intake Spur Big Drops in Heart Trouble
Chinese Red Yeast Rice May Prevent Heart Attack
INFECTIOUS DISEASE
Chinese 'Devil Dung' Plant Could Be a Swine Flu Fighter
Older Adults May Have Some Immunity to Swine Flu
More Medicinal Uses for Pomegranate
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Frequent Feedings May Be Making Babies Fat
Treat Kids to a Safe Halloween
Scary Toxins Make Halloween Face Paints Questionable
MEN'S HEALTH
Physical Activity May Prolong Survival After Colon Cancer
Eating Fast Until Full Triples Overweight Risk
More Vitamin C May Mean Less Chance of Gout
MENTAL HEALTH
Worries About Weight Are Tied to Teen Suicide Tries
Psychotherapy Can Boost Happiness More Than Money
Memory Loss Help from Brain Supplement Prevagen
PAIN
Alleviating Rheumatoid Arthritis
Tai Chi May Help Ease Fibromyalgia
Acupuncture, Real or Fake, Eases Back Pain
PHYSICAL THERAPY
PREGNANCY
Exercise As Well As Acupuncture, May Ease Polycystic Ovarian Syndrome
Mom's Extra Pregnancy Pounds May Raise Child's Heart Risks
For Baby and Mom Alike, Breast-Feeding May Be Best
SENIORS
Friends, Not Grandkids, Key to Happy Retirement
For a Healthier Retirement, Work a Little
Seniors Who Volunteer May Live Longer
SEXUAL HEALTH
SLEEP DISORDERS
Lose Weight, Sleep Apnea May Improve
Meditation May Help Put Primary Insomnia to Bed
Exercising Throat Muscles May Relieve Sleep Apnea
WOMEN'S HEALTH
Simple Carbs Pose Heart Risk for Women
Broccoli May Help Battle Breast Cancer
Vitamin D Good for Breast Cancer Patients
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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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