Wednesday, October 17, 2012

The Box Concerning Congestive Heart Failure

“Think outside the box!” These words show up in commercials, boardrooms, operating rooms and casual conversations. They have become the calling card of the young creative hotshot trying to secure an impressive position in a choice company. They mark the inventive thinker and condemn the one doing everything in the same old fashion. For the most part we live in a world where new is better and change in and of itself is considered a good thing.
But there are some boxes in which our thinking seems to be locked. I have in mind one particular box which conforms us to the idea that health is a matter of fixing problems after they present themselves. There is no doubt that medical science has advanced at a remarkable rate. We are daily finding cures for diseases that have plagued us for all history. But medical science is not the savior of careless living. It is time to think outside the box of waiting until there is an evident problem before we do anything about it. Or perhaps it is more accurate to say that we should return to the box that says, “An ounce of prevention is worth a pound of cure.”
One case in point, among many others, is demonstrated by the rise in heart disease in developed and developing countries. In particular to this article is the increase in incidence of congestive heart failure. Congestive heart failure is not so much a disease as it is the end result of heart degradation. Sometimes the cause is not known. But most often it is caused by one or more long-term ailments that stress the heart to the point that it simply can not function properly.
Here is an example. Perhaps a patient has lived with elevated blood pressure for many years. Long-term hypertension is one of the leading causes of CHF. The patient might make some efforts to reduce his blood pressure but is not overly concerned about it. After all, we live in a high speed world. Hypertension is common among the hard working. It becomes an acceptable part of every day living in the modern world.
But high blood pressure is one common condition that works for years to wear on the cardiovascular system resulting in a number of serious ailments, not the least of which is congestive heart failure. The fact that something does not kill us in a week does not logically imply that it will not kill us. Hypertension causes the heart to work harder ultimately weakening it over time. The weakening of the heart coupled with a vascular system not conducive to efficiently transporting blood due to hypertension and atherosclerosis (clogging of the arteries) can only lead to trouble. The heart gets to the point that it simply can not keep up with the work load. The patient then turns to medical science for a cure; or perhaps a miracle. Twenty years of neglect, and even abuse, is expected to fade away with the swallowing of a few pills.
The blood pressure example is just that, an example. Atherosclerosis is another. Atherosclerosis comes from the Greek words athero (meaning gruel or paste) and sclerosis (meaning hardness). The combination of the two meanings provides a rather gruesome picture of a hard paste (plaque) being deposited in our blood vessels. Not a pretty sight from any angle. When plaque buildup sufficiently restricts blood flow to the major organs serious repercussions can occur not the least of which is heart attach, stroke or long-term congestive heart failure.
It is believed by many scientists that atherosclerosis begins when damage occurs to the innermost layer of the artery. Such damage can be caused by high levels of cholesterol and triglycerides, high blood pressure, smoking, diabetes and obesity. It stands to reason, then, that controlling these conditions can go a long way toward reducing the effects of atherosclerosis and, by logical inference, congestive heart failure.
There are many more possible examples that could be given. The above represent only a couple common possibilities. But notice even in these two examples the amount of overlap. High blood pressure affects atherosclerosis buildup. Smoking has an effect on both conditions. It is the same with other conditions as well. The same, then, is also true with treatments. Taking steps to control one area of heart health usually provides beneficial results in other areas. And these benefits in return aid in prevention and treatment of CHF.
So what magical steps can we take to reduce the likelihood of developing CHF? No magic. In a sense what we need to do is to stop thinking inside the box of waiting until there is a health problem before we do anything about it. But in so doing, we need to return to an even older box; the box of prevention.
Health is, in a large part, a matter of lifestyle. Why is heart disease, and particularly congestive heart failure, on the rise in developing countries? One word: Lifestyle. While medical science is working to reduce the impact of heart disease we are working to increase its impact.
The first major factor to concern us is the lack of exercise. Most of us have jobs that exercise our brains but not our bodies. This is especially the case for those of us who are in the busy time of our lives while building careers and raising children. It is difficult to add an exercise regimen on top of all the other responsibilities that scream for our time. However, being physically fit influences much more than the strength of our muscles. The whole body requires conditioning to function properly and heart health is no exception.
Diet is perhaps the main culprit in the rise of heart disease. Face it, with all the advertisements on the radio and television promoting low fat diets and healthy eating we still don’t listen. We are in a hurry so we eat what is convenient and tasty. High cholesterol, high fat diets simply do not promote heart health. They promote hypertension and atherosclerosis, both major factors in the development of CHF. Not only do we take in way too much of the bad stuff we don’t get nearly enough of the good stuff. Most of the vegetables in the average American diet come from French fries. And most of the fruits are found in the form of bottled drinks that boast 10% real fruit juice. If we treated our cars this way they wouldn’t last long enough to pay off the loan.
Even for those that make an effort to eat well there is an additional obstacle. Farming techniques often do not produce the nutritious foods that were once available. Hormonally adjusted livestock and chemically fertilized crops are not as healthy as their organically raised counterparts. Even nutritious crops begin losing their nutritious value as soon as they are picked. Fruits and vegetables that are stored and shipped over an extended period of time provide only a fraction of their original benefit.
So what are we to do? In addition to reducing the amount of fat and cholesterol there should be a concerted effort to add ample fruits and vegetables to the diet. Of course the organically grown varieties are superior. But they are not an option for everyone. However, in most places it is possible to buy produce that is locally grown. This usually means that less time passes between harvest and consumption reducing vitamin loss. Growing your own produce is a great alternative if you have enough space.
Fish, especially cold water fish, has long been known to aid in heart health. Cultures which include fish as a significant part of the diet have demonstrably lower incidence of heart disease than cultures that eat little fish. The Omega-3 fatty acids contained in fish oils have been shown in numerous studies to reduce heart disease of many types.
Even in the best diets there are holes. Consider a good dietary supplement regimen. Many studies have verified the usefulness of supplementing for the reduction and prevention of a number of diseases including heart diseases like CHF. The particulars of these studies are beyond the scope of this essay. But one thing should be emphasized. Choose good vitamin supplements. Good supplements are manufactured much the same way as good produce is grown. Chemical equivalents are not really equivalents. The test tube may not know the difference but the body does.