Pumping Marvellous

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Frightening Similarities

As you may or may not know one of the goals of Pumping Marvellous is to get Heart Failure patients to the specialists in cardio care they deserve. See our main site for our goals pumpingmarvellous.org.

In December 2010 the National Heart Failure audit indicated at least 5,000 sufferers in the UK die needlessly each year because they are treated on the wrong hospital wards, while others are prescribed too little medication to be effective.

The June edition of the American Heart Journal reported nearly 70,000 Americans die each year because they do not receive optimal therapy as called for in guidelines promoted by national health authorities, researchers said Monday. Physicians have been slow to implement many of the procedures called for in the guidelines, according to the first national study of adherence to the treatment goals, the team reported in the June edition of the American Heart Journal.

Dr. Gregg D. Fonarow of UCLA’s Geffen School of Medicine and his colleagues studied six evidence-based therapies for heart failure, using data from clinical trials, in-patient and out-patient registries for heart failure patients, quality-of-care studies and other published sources.The six treatments are highly recommended for heart failure patients by the American College of Cardiology and the American Heart Association. The researchers found that 2,644,800 heart failure patients were eligible for the therapies, but did not receive them. The total number of potential deaths that could be prevented each year with optimal implementation of all six therapies is 67,996, they reported.

The therapies included four different families of drugs, cardiac resynchronization therapy (which helps coordinate heart contractions and arrythimias) and implantable cardioverter-defibrillators (which shock hearts beating erratically back into a normal rhythm). The estimated number of lives that could be saved by wide implementation of each therapy, they estimated, are:

– Aldosterone antagonists, 21,407.

– Beta blockers, 12,922.

– Angiotensin-converting enzyme (ACE) inhibitors, 6,516.

– Hydralazine/isosorbide dinitrate, 6,655.

– Cardiac resynchronization therapy, 8,317.

– Implantable cardioverter-debrillators, 12,179.

The findings “have significant clinical and public health implications” because tens of thousands of lives could be saved with optimal implementation of the therapies, Fonarow said in a statement. Pointing out which therapies are not sufficiently used, he added, will push clinicians toward a more careful examination of their treatment strategies.

Ace inhibitors and a cough

Some people notice that they get a ticklish, dry cough when they first start taking ACE-inhibitor drugs like ramipril. Usually this gets better in a few weeks as your body gets used to the new drug. Starting at a low dose and building the dose up slowly helps.  More than often the cough is due to something else but in other cases it can be persistent.
It is rare for the cough to be severe and persistent from taking an ACE-inhibitor, enough to make you want to stop taking the drug, but if it is, there are several options so don’t worry. There is another class of drugs that blocks the receptor that the Angiotensin Converting Enzyme acts on. These ACE receptor blocker drugs usually end in “-artan,” so you will see names like losartan or candesartan. These drugs seem to have similar effects to the ACE-inhibitors. They do not cause a cough and are therefore easier to take for people who have trouble taking ACE-inhibitors. The ACE receptor blockers have not been on the market as long as ACE-inhibitors, and there are not as many long-term research studies about them, but what is known so far is very encouraging. Like the ACE-inhibitors, they help lower the blood pressure and seem to protect the kidneys from damage that causes you to lose protein in your urine.

The reson why these class of drugs are prescribed to heart failure patients is that “in patient speak” it widens the blood vessels and they become a little bit more elastic therefore taking some of the strain and stress off the heart as the blood vessels and arteries are wider. It is very important to keep taking your prescribed drugs but if there is a problem then there is generally another solution like mentioned above.