Heart failure is the term used when a heart is not pumping as well as it should. When you have heart failure, it does not mean your heart has stopped beating. It does mean that your heart no longer pumps enough blood rich in both oxygen and nutrients to the rest of your body. Sometimes you might hear this condition called congestive heart failure. (Technically, that means heart failure with symptoms of excess fluid retention in parts of your body.)
The cause of heart failure is almost always some underlying illness or disease that's injured your heart over time. High blood pressure and diabetes are often to blame — especially if they haven't been well controlled with proper medicines. Sometimes other problems, like hardening of the arteries or a heart attack, set heart failure in motion. Most of these heart-unfriendly conditions are more common in African Americans than in other ethnic groups. This may help explain why African Americans are 50% more likely to experience heart failure than other Americans.
Heart failure doesn't happen overnight
Heart failure usually comes on gradually. To make up for its loss of pumping power, your heart first tries to work harder to get its job done. It might pump faster than usual. These changes might help your heart work the same for a while — and you probably won't notice that anything is different. Eventually, however, your weakened heart won't be able to keep up. That's when telltale symptoms of heart failure begin to appear. You may feel worn out and short of breath just climbing the stairs, for instance, or you may notice swelling in your feet and legs. Once you notice these or other symptoms, it's important to visit your doctor right away. Once symptoms start, they can get worse quickly without proper treatment. This is particularly true for African Americans. Although heart failure is on the rise all across America, it hits the African American community hardest.
Common types of heart failure
Your heart is divided into two halves, which are like two pumps working side by side. Heart failure can affect one side or both sides of your heart. Most cases involve damage to the heart's left side. This is called left-sided heart failure. It means the heart can't pump enough oxygen-rich blood out to the rest of your body.
In cases of right-sided heart failure, the right side of the heart has trouble pumping blood to the lungs, where the blood picks up oxygen. Learning the basics of how the heart works can help you understand what happens when heart failure occurs. Heart failure is caused by one or more underlying conditions that have damaged or overworked your heart. Over time, your heart's ability to pump blood weakens.
Common causes of heart failure
- Coronary artery disease (CAD) is the most common cause of heart failure in America. In someone with CAD, the arteries that supply blood to the heart become narrow when a fatty substance called "plaque" builds up in the artery wall. (Some people take cholesterol-lowering medicines to prevent or treat this plaque buildup.) Plaque can block the flow of blood and oxygen to the heart, leading to chest pain (angina) or heart attack.
- A heart attack places you at high risk for heart failure. When a heart attack happens, part of the heart actually becomes permanently damaged. The healthy heart tissue that remains must pump even harder to keep up. This increased stress/workload can lead to a loss of function.
- High blood pressure is another major cause of heart failure, especially among African Americans. When high blood pressure is not well controlled with proper medication, it puts extra strain on your heart and blood vessels with every beat. High blood pressure is 33% to 50% more prevalent in African Americans than in other American adults.
- Diabetes increases the heart's workload, especially if it is not regularly monitored and controlled with medication. Diabetes is associated with a higher prevalence of heart failure. About 60% more African American Americans have diabetes compared with other ethnic groups.
Other causes of heart failure
Although they're less common, many other heart conditions can also lead to heart failure, including:
- Cardiomyopathy (inflammation of the heart muscle)
- Diseases of the heart valves
- Arrhythmia (abnormal heartbeat)
- Congenital heart disease or heart defects (heart problems you were born with)
Certain other conditions can also damage the heart and lead to heart failure, including:
- Cancer treatments (radiation and some chemotherapy drugs)
- Thyroid gland disorders
- Alcohol abuse
- Use of cocaine or other illegal drugs
Information for Patients about BiDil®
BiDil is approved for use with other heart medicines to treat heart failure in black patients to improve survival, improve heart failure symptoms, and help patients stay out of the hospital longer. There is little experience in patients with heart failure who experience significant symptoms while at rest. Most patients in the clinical study of BiDil also received other heart failure medicines.
IMPORTANT SAFETY INFORMATION
Tell your doctor about any allergies you have, especially if you're sensitive to nitrates, such as nitroglycerin tablets or isosorbide dinitrate (Isordil®). BiDil has a nitrate component, so you need to let your doctor know.
WARNINGS AND PRECAUTIONS
Tell your doctor if you're taking any erectile dysfunction or pulmonary hypertension drugs like Viagra® or Revatio™ (sildenafil), Levitra® (vardenafil) or Cialis® (tadalafil). Mixing these with BiDil may cause a sudden drop in blood pressure, fainting, chest pain, or heart attack.
Also tell your doctor if you are taking any medication to decrease blood pressure because when taken with BiDil, blood pressure may become too low.
It is possible you'll get headaches, especially at first, but they often lessen over time. For some patients, Tylenol® (acetaminophen) helps ease the discomfort. Keep your doctor posted on your headache progress and Tylenol use; he or she may want to adjust your dosage.
If you experience dizziness, call your doctor. Please make sure to tell your doctor about any of the signs or symptoms mentioned below or about any unusual events that worry you.
Drinking less fluids than your doctor recommends or losing fluid due to diarrhea, sweating, or vomiting may cause low blood pressure, lightheadedness, or fainting. If fainting occurs, stop taking BiDil and contact your doctor immediately.
Lightheadedness may occur when standing, especially after sitting or lying down.
If you experience any achy and/or swollen joints, unexplained fever for more than a few days, skin rashes, chest pain, prolonged weakness or fatigue (even after a good night's sleep), or any other unexplained signs or symptoms, make sure to tell your doctor as they may be signs of a serious medical condition.
You may also experience rapid heartbeat that could lead to chest pain or aggravate chest pain, or numbness or tingling in the hands or feet.
COMMON SIDE EFFECTS
Headache and dizziness were the most frequent side effects experienced in studies with BiDil. Other side effects included chest pain, weakness, nausea, chest infection, low blood pressure, sinusitis, palpitations, high blood sugar, runny nose, tingling, vomiting, impaired vision, high cholesterol, and rapid heart rate.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please click here to see full Prescribing Information for BiDil. This information does not take the place of talking with your healthcare provider about your condition or your treatment. Ask your doctor if BiDil may be right for you.
Isordil is a registered trademark of Biovail Laboratories International SRL; Viagra is a registered trademark and Revatio is a trademark of Pfizer Inc.; Levitra is a registered trademark of Bayer Aktiengesellschaft and is used under license by GlaxoSmithKline; Cialis is a registered trademark of Eli Lilly and Company; Tylenol is a registered trademark of McNEIL-PPC, Inc.