My Adventures with Heart Failure

Apparently, the marketing people from Coreg read this blog. They asked me if I'd be willing to add a link to Coreg's web site. I checked out the site, and decided that it would be worthwhile to add a link to the part of their web site that specifically discusses heart failure. There are some interesting bits of information in there, including differences in the incidence of heart failure among races, which I knew some of, but did not know that Mexican-American women have a lower incidence of heart failure than either Anglo or African-American women. So, you might also find interesting information by reading Coreg's site, despite its equally obvious commercial intent. It's by gathering information from as many sources as possible that we learn the most, right?

Another article of interest (I've been on antidepressants since long before I got diagnosed with CHF):

Depression Worsens Outcomes for Heart Failure Patients

March 6 (HealthDay News) -- Depression is a major factor in poor medical outcomes for heart failure patients, says a new U.S. study.
The study, conducted by researchers at Duke University Medical Center and the University of North Carolina, included 204 heart failure patients who were followed for an average of three years. Tests showed that 46 percent of the patients had significant symptoms of depression. During the study period, 26 percent of the patients died, and 48 percent were hospitalized at least once for their heart
condition.
The researchers concluded that patients with depression were more
than 50 percent likely to die or be hospitalized for their heart condition than
patients who weren't depressed. This means that, in heart failure patients, depression ranks in importance with risk factors such as high cholesterol, hypertension and even the ability of the heart to pump blood throughout the body, the study authors said.
"While many studies have linked depression to worse outcomes for patients with heart disease, there has been uncertainty about the extent to which depression is related to the adverse medical outcomes independent of known medical risk factors," study co-author James Blumenthal, a clinical psychologist at Duke, said in a prepared statement.
It's not clear why heart failure patients with depression have worse outcomes. The researchers are launching a new clinical trial to further investigate depression in heart failure patients.
The study was published in the Feb. 26 issue of the Archives of Internal Medicine.

SOURCE: Duke University Medical Center, news release, February 2007

This is especially interesting in light of something my cardiologist told me back when I first got started on Coreg (carvedilol), which is that many people get depression as a side effect of taking beta-blockers until they get fully acclimated to them, and that for that reason while the dose of Coreg is being titrated, which takes weeks, the cardiologist asks questions at every visit intended to detect depression and consider prescribing anti-depressants. So, depression is a side-effect of one of the medications used to treat heart failure, and depression can lead to worse outcomes in heart failure... we're sort of in a catch-22, aren't we!!

This is, of course, NOT a message that you should stop taking your Coreg; for one thing, for most people the benefits of the beta-blocker undoubtedly outweigh the risks, and for another thing, discontinuing any medication suddenly is a bad idea, and especially a bad idea for certain drugs including beta-blockers. Suddenly stopping taking your Coreg could land you in the hospital right quickly. However, if you are taking Coreg and feel fatigued, listless, have trouble concentrating, or have trouble sleeping through the night, these could be signs of depression, and you should ask your doctor about appropriate additional treatment for depression.

This week's article:

Lipitor Approved for Additional Uses
March 8
(HealthDay News) -- Pfizer's anti-cholesterol drug Lipitor (atorvastatin)
received expanded approval from the U.S. Food and Drug Administration on
Wednesday to reduce users' risks of non-fatal heart attack, fatal and non-fatal
strokes and hospitalization for heart failure, and for use in certain types of
heart surgery, the company said.
The new approvals expand use of Lipitor to people who have had a prior heart attack, heart surgery or chest pain.
The expanded approval of the 80 mg. dose was based on a five-year trial involving people with both heart disease and elevated levels of LDL, the so-called "bad" cholesterol, Pfizer said. The company added that the trial was the longest and largest study of the 80 mg. dose's safety and effectiveness.
More than 15 million Americans have a history of coronary heart disease, Pfizer said, adding that about 300,000 Americans are expected to have a recurrent heart attack this year.
Lipitor was first approved by the FDA in 1996 to treat high cholesterol.