Treating Cardiac Edema
If Heart Disease Runs In Your Family, Talk To Your Doctor About HCM
Sponsored by and provided by Bristol Myers Squibb
Kristin Criss is a paid spokesperson on behalf of BMS Bristol Myers Squibb When Kristen Criss was diagnosed with hypertrophic cardiomyopathy (HCM), it felt like the pieces of her family's health puzzle had finally fallen into place.
"My mom passed at 40-years-old, and my sister passed at age 33, so we always knew there was heart disease in our family," she says. "When we finally got the genetic component figured out, we realized it all matched up to HCM."
Kristen is far from alone. HCM is the most commonly inherited heart disease and is estimated to affect between 1 in 200* to 1 in 500[†] people in the U.S.[1] However, it is estimated that only about 100,000 individuals in the U.S. Currently have received an HCM diagnosis, suggesting approximately 85% may remain undiagnosed.[‡§] The condition can lead to serious health complications, including an increased risk of heart failure, atrial fibrillation (irregular heartbeat), stroke, and, in rare cases, sudden cardiac death.[2]
To raise awareness and encourage those who may be at risk to speak with their doctors, select states across the country, are officially observing Hypertrophic Cardiomyopathy Awareness Day on Wednesday, February 28, 2024.
Understanding HCM
HCM is a chronic and progressive disease that can affect the function of the heart. It can affect an individual at any age, but people are typically diagnosed in their 40s or 50s.[3] While HCM is often inherited, not all cases are genetic.[4]
In HCM, the left ventricular wall of the heart becomes thicker than it should be.[4] This excessive thickening can cause the heart to become stiffer.[4] As a result, the heart works harder and may have difficulty pumping oxygen-rich blood to the rest of the body.[4]
There are two types of HCM - non-obstructive HCM and obstructive HCM (oHCM) - both of which result in thicker heart walls.[4] The majority of HCM cases are obstructive in nature, meaning the heart's thicker wall may block or reduce blood flow out of the heart.[5]
Becoming Aware of HCM Symptoms
HCM is sometimes described as a "hidden disease" because people who have it may not always experience symptoms, or the symptoms may be similar to that of other health conditions.[6] Common symptoms include shortness of breath, unexplained tiredness, a rapid heartbeat, chest pain, dizziness, and fainting.[4]
Symptoms can vary from person to person. In some, they come and go, and in others, symptoms are persistent. They can make everyday activities like walking, climbing stairs, exercising, getting dressed, shopping, and household chores more difficult.
"I continue to face challenges from HCM," adds Kristen. "I can't work out, play games or sports with my kids, or go on the long walks and hikes that I used to enjoy."
Your doctor may check you for HCM if someone in your family has the condition, you have symptoms such as a heart murmur, or your heart is functioning in an abnormal way, based on an electrocardiogram or echocardiogram.
Your doctor may also request an MRI of the heart, a stress test, and monitor your heart for any abnormal heart rhythms. Genetic testing can also be used to support a diagnosis. It's important to know if there is a genetic component to your HCM. If there is, other family members can be checked for the condition.
Taking Charge of Your Heart Health
Being aware of your family history of heart disease and your own unexplained or worsening symptoms is an important first step. People with HCM may think they have asthma, anxiety, or another heart-related condition.[6] It is easy to think, "It's nothing," or "I'm just out of shape or stressed," but a delayed or missed diagnosis can put your health at risk. It's important to understand that symptoms may be signs of other conditions and only your doctor can determine if you have HCM or another condition.
Ask yourself the following questions before you visit your doctor:
• Do I have any symptoms that might be indicative of HCM?• Have I changed any of my activities because they are too difficult to physically do?• Does anybody in my family have HCM?• Am I related to anybody who has died suddenly or unexpectedly before the age of 50?
"Now that I'm working with my doctor on a management plan that works for me, I'm hopeful about living a more normal life - playing with my kids and going on hikes," says Kristen.
If you are experiencing any of these symptoms or if someone in your family was diagnosed with HCM, it's important to talk to your healthcare provider to learn more. Symptoms can be representative of many health conditions. Only a doctor can determine whether these symptoms indicate HCM or another condition.
To learn more, visit CouldItBeHCM.Com.
Footnotes:
* The 2015 Semsarian publication identified that the prevalence of HCM gene carriers could be as high as 1:200.
[†] The 1995 CARDIA study, a multicenter, US-population-based echocardiography study of 4111 subjects (aged 23-35), identified the prevalence of HCM as 1:500 people in the general population.
[‡] Based on 2013 ICD-9 claims data analysis (N=169,089,614): An estimated 700,000 overall US prevalence of HCM (1. ~100,000 patients with diagnosed HCM [based on 2013 US Census population], 2. ~600,000 patients with undiagnosed HCM [based on analysis' assumption that 1 in 500 prevalence represents clinically unrecognized cases]).
[§] Estimated undiagnosed range calculated using prevalence of 1:500, estimated US population (332,330,571 in May 2021), and estimated diagnosed population (~100,000).
References:
[1] Wolf CM. Hypertrophic cardiomyopathy: genetics and clinical perspectives. Cardiovasc Diagn Ther. 2019 Oct;9(Suppl 2):S388-S415. Doi: 10.21037/cdt.2019.02.01.
[2] Jacobs C. Hypertrophic cardiomyopathy in adults: an overview. J Am Assoc Nurse Pract. 2014;26(9):465-470.
[3] Elsouri KN, Camacho Ramos J, Stepanek K, Turan A, Kesselman MM, Demory ML. Adult Onset Hypertrophic Cardiomyopathy (HCM) Not Detected by Echocardiogram: A Case Presentation. Cureus. 2023 Sep 25;15(9):e45932. Doi: 10.7759/cureus.45932. PMID: 37885492; PMCID: PMC10599216.
[4] University of Maryland Medical Center. Hypertrophic cardiomyopathy types, symptoms and causes. Https://www.Umms.Org/ummc/health-services/heart-vascular/services/hypertrophic-cardiomyopathy/types-symptoms-causes.
[5] Ommen SR, Mital S, Burke MA, et al. 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2020;142(25):e558-e631.
[6] Argulian E, Sherrid MV, Messerli FH. Misconceptions and facts about hypertrophic cardiomyopathy. Am J Med. 2016;129(2):148-152.
© 2024 MyoKardia, Inc., a Bristol Myers Squibb company. CV-US-2400028 02/24
Not Getting Enough Sleep Can Increase Women's Risk Of Heart Disease By 75%
The sleep habits you develop in the middle of your life can have a profound impact on your future heart health, according to new research.
The study, recently published in the journal Circulation, found that regularly sleeping fewer than seven hours a night and waking up too early or throughout the night can increase a person's future risk of stroke, heart attack, and myocardial infarction.
Cardiovascular disease (CVD) is the leading cause of death in women, and poor sleep is a major health issue for women, especially in midlife.
While previous studies have looked at how a poor night's sleep is related to the development of heart disease, it's been unclear how long-term sleep problems impact the risk of heart disease.
The new findings suggest that long-term sleep issues and heart disease are closely linked and underscore the need to improve heart disease prevention efforts in women.
"More women will die from cardiac disease than from cancer. With control of risk factors we can actually prevent heart disease in women," Dr. Eleanor Levin, a cardiologist with Stanford Medicine, told Healthline.
The researchers evaluated the sleep habits and health outcomes of 2,964 women between 42 and 52 years of age.
The participants were premenopausal or early perimenopausal, not using hormone therapy, and did not have heart disease.
Over 22 years, the participants completed up to 16 visits where they completed questionnaires about their sleep habits, including whether they have insomnia symptoms and how long they typically sleep, along with mental health issues, like depression, and vasomotor symptoms, such as hot flashes.
The questionnaire also included questions about their anthropometric measurements, such as their height and weight, blood draws, and heart events, such as myocardial infarction, stroke or heart failure.
Roughly one in four of the women regularly experienced insomnia symptoms, such as trouble falling asleep, waking up in the night, or waking up earlier than planned, and 14 percent frequently dealt with short sleep duration.
About 7% reported habitual insomnia symptoms and short sleep duration.
The researchers discovered that those who had chronically high insomnia symptoms had a higher risk of developing CVD later in life.
In addition, women who regularly slept less than five hours a night had a slightly higher risk of heart disease.
Individuals who persistently had high insomnia symptoms and slept less than five hours a night had a 75% higher risk of heart disease, even when the researchers adjusted for CVD risk factors.
According to the researchers, the findings highlight the impact long-term sleep problems can have on women's heart health.
There are multiple explanations as to why poor sleep can impair heart function over time.
"Poor sleep likely negatively impacts heart health through a combination of mechanisms, such as increasing sympathetic nervous system activity, dysregulating autonomic nervous system activity, and increasing systemic inflammation," said Dr. Cheng-Han Chen, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA.
Poor sleep quality is associated with an increased risk of hypertension and insulin resistance, both risk factors for heart disease.
"Lack of sleep makes high blood pressure worse and can lead to bad eating habits with more carbohydrates and sugars, making prediabetes and cholesterol worse," says Levin.
In addition, many people with insomnia also have sleep apnea, which is a known risk factor for heart disease.
Women have different heart disease symptoms than men and are less likely to be treated properly.
Chen says it's essential that the medical community address sleep problems in women as part of their overall cardiovascular health management.
Experts say you should aim get about seven to eight hours of sleep a night. People looking to improve their sleep can take the following steps:
Medications can be prescribed to treat insomnia and a CPAP (continuous positive airway pressure) machine can be used by those with sleep apnea.
"Extra attention needs to be paid in preventing the underlying risk factors of cardiovascular disease — such as hypertension, diabetes, and poor sleep — in order to improve their health outcomes," Chen said.
New research shows that long-term sleep issues can increase your risk of heart disease later in life. Heart disease is a leading cause of death in women, and the new findings underscore the need to improve heart disease prevention efforts in women.
Hypertensive Heart Disease
What is hypertensive heart disease?
Hypertensive heart disease refers to heart conditions caused by high blood pressure.
The heart working under increased pressure causes some different heart disorders. Hypertensive heart disease includes heart failure, thickening of the heart muscle, coronary artery disease, and other conditions.
Hypertensive heart disease can cause serious health problems. It's the leading cause of death from high blood pressure.
In general, the heart problems associated with high blood pressure relate to the heart's arteries and muscles. The types of hypertensive heart disease include:
Narrowing of the arteriesCoronary arteries transport blood to your heart muscle. When high blood pressure causes the blood vessels to become narrow, blood flow to the heart can slow or stop. This condition is known as coronary heart disease (CHD), also called coronary artery disease.
CHD makes it difficult for your heart to function and supply the rest of your organs with blood. It can put you at risk for heart attack from a blood clot that gets stuck in one of the narrowed arteries and cuts off blood flow to your heart.
Thickening and enlargement of the heartHigh blood pressure makes it difficult for your heart to pump blood. Like other muscles in your body, regular hard work causes your heart muscles to thicken and grow. This alters the way the heart functions. These changes usually happen in the main pumping chamber of the heart, the left ventricle. The condition is known as left ventricular hypertrophy (LVH).
CHD can cause LVH and vice versa. When you have CHD, your heart must work harder. If LVH enlarges your heart, it can compress the coronary arteries.
ComplicationsBoth CHD and LVH can lead to:
Heart disease is the leading cause of death for both men and women in the United States. Over 695,000 Americans die from heart disease every year.
The main risk factor for hypertensive heart disease is high blood pressure. Your risk increases if:
You're more prone to heart disease if it runs in your family. Men are more likely to get heart disease than women who have not gone through menopause. Men and postmenopausal women are equally at risk. Your risk for heart disease will increase as you age, regardless of your sex.
Symptoms vary depending on the severity of the condition and progression of the disease. You may experience no symptoms, or your symptoms may include:
You need emergency care if your heart is suddenly beating rapidly or irregularly. Seek emergency care immediately or call 911 if you faint or have severe pain in your chest.
Regular physical exams will indicate whether you suffer from high blood pressure. If you do have high blood pressure, take extra care to look out for symptoms of heart disease.
Your doctor will review your medical history, conduct a physical exam, and run lab tests to check your kidneys, sodium, potassium, and blood count.
One or more of the following tests may be used to help determine the cause of your symptoms:
Treatment for hypertensive heart disease depends on the seriousness of your illness, your age, and your medical history.
MedicationMedications help your heart in a variety of ways. The main goals are to prevent your blood from clotting, improve the flow of your blood, and lower your cholesterol.
Examples of common heart disease medications include:
It's important to always take all medications exactly as prescribed.
Surgeries and devicesIn more extreme cases, you may need surgery to increase blood flow to your heart. If you need help regulating your heart's rate or rhythm, your doctor may surgically implant a battery-operated device called a pacemaker in your chest. A pacemaker produces electrical stimulation that causes cardiac muscle to contract. Implantation of a pacemaker is important and beneficial when cardiac muscle electrical activity is too slow or absent.
Cardioverter-defibrillators (ICDs) are implantable devices that can be used to treat serious, life-threatening cardiac arrhythmias.
Coronary artery bypass graft surgery (CABG) treats blocked coronary arteries. This is only done in severe CHD. A heart transplant or other heart-assisting devices may be necessary if your condition is especially severe.
Recovering from hypertensive heart disease depends on the exact condition and its intensity. Lifestyle changes can help keep the condition from getting worse in some cases. In severe cases, medications and surgery may not be effective in controlling the disease.
Monitoring and preventing your blood pressure from getting too high is one of the most important ways to prevent hypertensive heart disease. Lowering your blood pressure and cholesterol by eating a healthy diet and monitoring stress levels are possibly the best ways to prevent heart problems.
Maintaining a healthy weight, getting adequate sleep, and exercising regularly are common lifestyle recommendations. Talk to your doctor about ways to improve your overall health.
How serious is hypertensive heart disease?Hypertensive heart disease is a serious condition that requires treatment. It increases your risk of death and puts you at risk of developing other cardiovascular diseases like heart failure, atrial fibrillation, and stroke, as well as chronic kidney disease.
How long does it take for hypertension to cause heart damage?Long-term high blood pressure ultimately leads to heart damage, and often heart failure. The length of time to develop heart damage varies for each person and depends on how uncontrolled your blood pressure is and what markers are used to determine LV damage. Treatment of high blood pressure can help prevent damage to the heart.
Can heart damage from hypertension be reversed?A 2016 study found that after 6 months of treatment, a person had succeeded in reversing heart damage caused by hypertension. That said, it's not always possible to reverse heart damage caused by high blood pressure. Following a well-development treatment plan can help you manage symptoms and prevent disease progression.
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