Advocacy

 

Congestive Heart Failure ("CHF")


 

In this form of heart problem, the heart does not pump as strongly as it should. The body becomes starved of blood and oxygen. The weakened heart also causes a backup of fluid (congestion) in the lungs and other parts of the body.

Symptoms of CHF include exhaustion, swelling of the feet and ankles, shortness of breath, chronic coughing, nausea, sudden weight gain and increased need to urinate at night.

Excessive alcohol use is one of several causes for CHF (probably because the high alcohol use often leads to high blood pressure).
   


According to the Heart and Stroke Foundation, there are simple ways to reduce the risk of developing heart failure. These  include quitting smoking, losing excess weight, regular exercise and healthy eating. If  a person develops  heart failure,  they can often manage the condition by a combination of healthy lifestyle choices and medications.

The Foundation notes that people living with CHF should:


    - Limit the amount of sodium in their diet
    - Limit the amount of fluid they drink
    - Weigh themselves regularly to watch for fluid buildup, which can often be detected by weight gains
    - Restrict their consumption of alcohol to no more than two drinks a day
    - Be smoke free
    - Balance their physical activity with rest - being active on a regular  basis is important, but too much exertion in a short period will lead  to fatigue.
 



Some Medications for CHF Can Adversely Interaction with Alcohol

There are five common groups of medications for congestive heart failure, each working in different ways to help the heart:

  1. aldosterone antagonists,

  2. angiotensin converting enzyme (ACE) inhibitors,

  3. beta blockers,

  4. diuretics, and

  5. digoxin (Lanoxin®). 

 

It is recommended that people avoid drinking alcohol if taking the beta blocker propranolol ("INDERAL") because the combination lowers blood pressure too much.


 

The new Canadian Heart And Stroke Foundation publication "Managing Your Congestive Heart Failure," recommends that people with congestive heart failure reduce their alcohol use to no more than one drink per day. This is equal to a glass  of wine (5 oz./150 mL/12% alcohol), beer (12 oz./350 mL/  5% alcohol), or one mixed drink (1 1/2 oz./50 mL/ 40% alcohol).

 

In some types of heart failure, alcohol must be totally avoided and people should talk with their doctor about alcohol, their medical condition and the medications they are on.

The publication notes, at page 25:

"You need to discuss drinking alcohol with your  doctor because:

 Alcohol may change how your medication works;

 Alcohol can affect other medical conditions you may have;

 Alcohol reduces the strength of the heart’s contraction;

 Alcohol may cause or worsen irregular heart rhythm."


Alcohol's Interaction with Other Heart Drugs 

 

The National Consumer's League in the United States in their handy brochure  also identifies how alcohol may interact with other heart drugs:

NITRATES

Nitrates relax blood vessels and lower the  demand for oxygen by the heart. Some examples are: isosorbide dinitrate (e.g. ISORDIL,  SORBITRATE)

nitroglycerin (e.g. NITRO, NITRO-DUR, TRANSDERM-NITRO)

Alcohol's Interaction with this medication: Avoid alcohol because it may add to the blood vessel-relaxing effect of nitrates and result in dangerously low blood pressure.

 

HMG-COA REDUCTASE INHIBITORS

Otherwise known as "statins," these medications are used to lower cholesterol.

Alcohol's Interaction with this medication: "Avoid drinking large amounts of  alcohol because it may increase the risk of liver damage."

 


For Alcohol Counsellors: Helping Clients Who Have CHF

CHF is fairly common among older people who have had long time drinking problems. In terms of helping seniors while they are dealing with the alcohol problem, it is important to understand that CHF can be very draining on the person's energy. The extent of limitations, will depend on the stage of the disease. In order to help best, go at a pace that is appropriate to the person's physical energy. It can be helpful to try to keep sessions and interviews on the shorter side. Working with the client, and the person's doctor, you can help determine kinds of activities and exercise that the person can safely become involved with, important considerations to promoting overall wellbeing.

By the way, did you know that depression is associated with an increased risk of coronary heart disease in general and myocardial infarction (heart attack) in particular. (from Medline www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZUKQQ9EPC&sub_cat=73)

 

 


 

References

Heart and Stroke Foundation of Canada, Managing Your Congestive Heart Failure

 

National Consumers League, Food and Drug Interactions www.nclnet.org/Food%20%26%20Drug.pdf

 

Page last updated Sunday October 31, 2004

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