Why aren't they trying to improve?
According to a study presented at Heart Failure 2019, a scientific congress of the European Society of Cardiology, only less than 10 percent of individuals diagnosed with heart failure comply with treatment recommendations prescribed by doctors. These treatments include advice on salt and fluid restrictions, physical activity and daily weighing. According to the researchers, loneliness is the primary culprit of this predicament.
“Loneliness is the most important predictor of whether patients adopt the advice or not,” said senior author Professor Beata Jankowska-Pola?ska, of Wroclaw Medical University, Poland. “Patients who are alone do worse in all areas. Family members have a central role in helping patients comply, particularly older patients, by providing emotional support, practical assistance, and advice.”
Loneliness is already established as a detrimental threat to those with cardiovascular disease. In another study, researchers found that lonely cardiac patients are at an increased risk of dying within a year from being discharged from the hospital. This finding suggests that loneliness is associated with the changes happening in the cardiovascular, neuroendocrine, and immune function.
The current study claims that not following any of the aforementioned lifestyle changes can contribute to worsening heart failure symptoms and even increase the risk of hospitalization. Because the heart cannot pump blood as efficiently as it normally does, heart failure patients who don't make these changes may experience breathlessness, swollen ankles and legs, as well as tiredness. Also, fluids may back up in the lungs and muscles deteriorate due to not receiving enough oxygen and blood. (Related: Heart failure worsens with anemia, increases risk of death.)
Checking on your weight daily can allow you to keep track of your fluid retention. On the other hand, restricting your salt and fluid intake can help keep your body's fluid retention under control. Researchers also mentioned that increasing physical activity in heart failure patients can improve energy levels and general quality of life. In this study, the researchers analyzed the adherence of these four non-drug treatment recommendations.
From the results, they observed that nearly 48 percent of the participants did absolutely no physical activity whatsoever, with 19 percent of them barely even exercising at all. 25 percent and 17 percent of heart failure patients never or very rarely follow the fluid restriction recommendations given by the doctors, respectively. In addition, 13 percent and 22 percent never or very rarely followed their doctors' salt intake restrictions. Lastly, more than half (54 percent) of the total participants only weighed themselves less than once a week, with 17 percent of them doing it once a week.
“It is worrying that fewer than one in ten patients observed all of the lifestyle advice,” said Jankowska-Pola?ska. “We also found that women were less compliant than men and patients over 65 had poorer scores than younger patients.”
The researchers' analysis revealed that a higher number of comorbidities, loneliness and more physically limiting heart failure symptoms were all independent predictors of non-compliance to the four recommended treatments. According to study author Natalia Swiatonioswka, patients with comorbid conditions might find it difficult to understand and follow most medical advice. For example, people with heart failure and kidney disease have at least ten pills to take as medication, meaning some guidance from doctors might seem conflicting.
The research team recommends that both doctors and nurses need to be proactive in encouraging better self-care in their heart failure patients. The patients should be given clearly written instructions on how to do certain treatments like exercising. They can also be sent texts or calls to remind them.
The biggest takeaway from the study is this: adopt and maintain healthy lifestyle changes if you want to get a healthy heart.
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