ALLERGY, RESPIRATORY
Asthmatics Who Quit Smoking May Reverse Lung Damage
Using Music and Sports to Improve Kids' Asthma
New Spray Could Benefit Cystic Fibrosis Patients
ALTERNATIVE MEDICINE
38% of U.S. Adults Use Alternative Treatments
Animals Respond to Acupuncture's Healing Touch
U.S. Spends Billions On Alternative Medicine
ANIMAL CARE
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
'Comfort Dogs' Come to Emotional Rescue
Animals Respond to Acupuncture's Healing Touch
BONES & JOINTS
In Elderly Women, Hip Fractures Often Follow Arm Breaks
B Cells Can Act Alone in Autoimmune Diseases
New Clues to How Fish Oils Help Arthritis Patients
CANCER
Well Water Might Raise Bladder Cancer Risk
Acupuncture May Help Relieve Polycystic Ovary Syndrome
More Cancer Tests Mean More False-Positive Results
CAREGIVING
Weekend Admission May Be Riskier for GI Bleeding
Early Exercise Boosts Outcomes for ICU Patients
Rapid Infant Weight Gain Linked to Childhood Obesity
CIRCULATORY SYSTEM
Common Antioxidant Might Slow Parkinson's
Walk 100 Steps a Minute for 'Moderate' Exercise
Bye, Bye Back Fat?
COSMETIC
New Genetic Links to Baldness Discovered
The Acne Drug Accutane More Than Doubles Depression Risk
Mouse Study Finds Molecule That Tells Hair to Grow
DENTAL, ORAL
Mom's Vitamin D Levels Affect Baby's Dental Health
Gum Care Helps Control Type 2 Diabetes and Its Complications
Gum Disease May Reactivate AIDS Virus
DIABETES
Vitamin K Slows Insulin Resistance in Older Men
Formula Puts Doctor, Patient Glucose Readings on Same Page
Coffee, Tea Might Stave Off Diabetes
DIET, NUTRITION
Fruit Even Healthier Than Thought: Study Shows
An Apple a Day May Help Keep Heart Disease Away
Compound in Berries May Lessen Sun Damage
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Chemical in Plastics May Cause Fertility Problems
Accumulated Lead May Affect Older Women's Brains
Hypertension May Hit Black Males Earlier
EYE CARE, VISION
Just Like Skin, Eyes Can 'Burn' in Strong Sun
Drinking Green Tea May Protect Eyes
Contact Lens Cases Often Contaminated
FITNESS
Tai Chi and Qigong Offer Many Health Benefits: Review
Higher Fitness Levels Tied to Lower Heart, Death Risks
As Temperature Plummets, It's Still Safe to Exercise
GASTROINTESTINAL PROBLEMS
Japanese Herbals May Ease Gastro Woes
New Guidelines Issued for Management of IBS
Bowel Prep Harder on Women Than Men
GENERAL HEALTH
Have a Goal in Life? You Might Live Longer
New Methods Could Speed Production of Flu Vaccines
Pesticides and How to Affordably Eat Organic or Reduce Pesticide Consumption
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Ski Helmets Encouraged for All
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
Combating Myths About Seasonal Allergies
Imaging Sheds Light on How Acupuncture Works
Using Light Therapy to Silence Harmful Brain Activity
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Rheumatoid Arthritis a Threat to the Heart
Years of Heavy Smoking Raises Heart Risks
Ingredient in Dark Chocolate Could Guard Against Stroke
INFECTIOUS DISEASE
Hand Washing 10 Times a Day May Help Keep Flu Away
Grapefruit Compound Inhibits Hepatitis C Virus
Chinese 'Devil Dung' Plant Could Be a Swine Flu Fighter
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Working Intensely Early on May Help Autistic Kids
Fussy Babys Could Be Out Of Your Control
Daily Exercise at School Yields Rewards
MEN'S HEALTH
Strenuous Daily Workout May Keep Cancer at Bay
Drinking Green Tea May Slow Prostate Cancer
Sunlight May Help Protect Men From Kidney Cancer
MENTAL HEALTH
Environmental Chemicals May Affect Male Reproduction
Massage Fosters Healing in Bereaved Relatives
Psychotherapy Can Boost Happiness More Than Money
PAIN
Tai Chi May Help Ease Fibromyalgia
'Cell Phone Elbow' -- A New Ill for the Wired Age
Alleviating Rheumatoid Arthritis
PHYSICAL THERAPY
PREGNANCY
Pre-Pregnancy Weight Linked to Babies' Heart Problems
Obesity May Affect Fertility in Young Womene
Acupuncture May Relieve Acid Indigestation In Pregnancy
SENIORS
Older Adults May Have Some Immunity to Swine Flu
Exercise Helps Reduce Falls in Young and Old
Nighttime Urination Linked to Higher Death Rate Among Elderly
SEXUAL HEALTH
SLEEP DISORDERS
Pay Attention to Signs That Say You're Too Fatigued to Drive
Better Sleep, Grades Seem to Go Up
Exercising Throat Muscles May Relieve Sleep Apnea
WOMEN'S HEALTH
Being Active an Hour a Day Puts Brakes on Weight Gain
Acupuncture May Ease Depression During Pregnancy
Natural Therapies for Menopause
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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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