Preventing the most common causes of heart failure

Some of the underlying causes of heart failure are difficult to prevent, since you're naturally more prone to them as you get older.

However, you can greatly reduce your risk of heart failure by getting treatment for these conditions and by staying on treatment, exactly as your doctor prescribes it. The better you and your doctor control conditions such as high blood pressure, high cholesterol, and diabetes, the less wear and tear on your heart.

That's why it's also important to get regular checkups to identify these serious health conditions, which come on "silently" without any obvious signs.

You can also reduce your risk for heart failure by embracing a healthy lifestyle that includes quitting smoking, losing weight as needed, exercising regularly, and eating a heart-healthy diet.

The most common symptoms of heart failure are:

• Shortness of breath
• Fatigue that develops quickly after little exertion
• Swelling in your feet, ankles, legs, or abdomen

You might experience all or just some of these common symptoms. Feeling short of breath happens because fluid builds up in and around your lungs when your heart's pumping action weakens. Weakening of the pumping action also leads to unusual tiredness or fatigue. At first, you might notice these symptoms only when you exert yourself more than usual — for instance, climbing the stairs or carrying heavy grocery bags.

As heart failure worsens, however, symptoms tend to worsen too. You might feel winded and tired after just walking across the room. Some people feel short of breath or develop a cough even when lying down, because fluid is backing up in their lungs. Fluid can also collect in other parts of your body when you have heart failure. This can cause swelling, especially in your feet, legs, or abdomen. The veins in your neck may also swell. The fluid buildup can also lead to rapid weight gain or the need to urinate more often.

It's not just your age

Some people might brush off a little "bloating," fatigue, and even huffing-and-puffing as normal signs of aging. Although other problems can also cause these symptoms, they should always be checked out by your doctor.

If you experience any of these symptoms, you should talk to your doctor. Heart failure can become a debilitating problem quickly, especially for African Americans. The sooner your doctor can diagnose and properly treat heart failure, the better your chances are for keeping symptoms from getting worse or from slowing you down. There is no single test for heart failure.

If you suspect you have heart failure, make an appointment with your doctor. Your doctor will ask about your health history and your symptoms and will conduct a thorough physical exam. Your doctor might also suggest certain tests that can help shed light on exactly what's causing your symptoms.

Visiting your doctor

The first thing your doctor will do is look for clues about what is causing your symptoms. This might include:

• Asking you to describe your symptoms in detail — including when they occur, how long you've experienced them, and how severe they are
• Determining whether you have certain diseases (like diabetes) or conditions (like high blood pressure) that can sometimes lead to heart failure
• Asking about the heart health of your family members
• Examining your ankles, feet, legs, abdomen, and neck veins for swelling
• Listening to your heart for abnormal sounds and to your lungs for signs of excess fluid
• Considering other possible causes of your symptoms

If your doctor suspects that you have heart failure, he or she will suggest certain tests. These can provide pictures of your heart and a measurement of how well it's working. You might also be referred to a cardiologist — a doctor who specializes in heart conditions.

Information for Patients about BiDil®

BiDil is approved for use in addition to routine heart medicines to treat heart failure in black patients, to extend life, 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 received routine 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 (Sorbitrate® or Isordil®). BiDil has a nitrate component, so you need to let your doctor know.

Tell your doctor if you're taking any erectile dysfunction or pulmonary hypertension drugs, like Viagra®/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.

Drinking alcohol when taking BiDil could make you feel very lightheaded. We recommend that you try to avoid drinking alcohol while taking BiDil.

It is possible you'll get headaches, especially at first. 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.

Sorbitrate is a registered trademark of AstraZeneca LP; Isordil is a registered trademark of Bioavail Corporation; Viagra is a registered trademark and Revatio is a trademark of Pfizer Inc.; Levitra is a registered trademark of Bayer Healthcare, GlaxoSmithKline, and Schering-Plough; Cialis is a registered trademark of Lilly ICOS LLC. Tylenol is a registered trademark of McNeil Pharmaceuticals, a Division of McNeil PPC, Inc.

Please see full Prescribing Information for BiDil.