Feb. 2, 2012 -- Two new studies shine a light on some lesser known consequences of heart failure: fractures and memory problems.
About 5 million people in the U.S. have heart failure, according to the American Heart Association. A chronic and progressive condition, heart failure occurs when the heart muscle can no longer pump enough blood to meet the body's needs. Symptoms may include swelling in the feet, ankles, and legs, tiredness, and shortness of breath. It is usually treated with medications aimed at relieving symptoms and helping the heart do its job.
One new study shows that people with heart failure are also at a 30% increased risk for major fractures. As a result, they may benefit from screening and treatment to make sure their bones stay strong. This study appears in Journal of Clinical Endocrinology & Metabolism.
The second report shows that people with heart failure may have memory problems and a loss of grey matter in their brain. These changes may make it more difficult for people with heart failure to take their medications as directed. The findings appear in the European Heart Journal.
Martha Grogan, MD, says the new studies tell us two important things about heart failure that we didn’t know before. Now “we need to think more about screening for osteoporosis and preventing fractures in people with heart failure. We also need a heightened awareness of the [mental] limitations of these patients.” She is an assistant professor of medicine at the Mayo Medical School in Rochester, Minn.
Heart failure often involves a complex treatment regimen that can be difficult to understand. Grogan likes patients to have a family member or caregiver at doctor appointments to understand the medications, the rationale for taking them, and the importance of being consistent on doses.
Richard S. Isaacson, MD, agrees. He is a neurologist at the University of Miami School of Medicine. “People with heart failure are going to have trouble understanding because their thinking skills are not as strong as they used to be. They often have multiple medical problems and difficulty understanding what they can do to help themselves,” he says. Handouts explaining heart failure and its treatments can often help remind people what they need to do and why they need to do it.
In the second study, Australian researchers ran mental tests on 35 people with heart failure, 56 people with another type of heart disease, and 64 healthy people. They also used magnetic resonance imaging scans to look at differences in the volume of grey matter in the brain.
People with heart failure had more problems with their immediate and long-term memory and had slower reaction speed than their healthy counterparts. The brain changes occurred in areas of the brain linked to demanding mental tasks and emotional processing.
Exactly why this occurs is not yet understood, the study authors report.