Deaths of heart failure are growing. Fresh treatments can lend a hand.

Ann Ramirez noticed for the first time that something was wrong when she began to wake up in the middle of the night at the age of 48. I felt like she was underwater and had to wait until the wave was passing to raise the air.

“It was very terrifying because you didn’t know how long this wave would last,” said 55 -year -old Mrs. Ramirez.

For months, she rejected problems as a flash of her asthma, anxiety associated with the recent diagnosis of father’s cancer or a sign of approaching menopause. But when she was finally checked, the doctor diagnosed Mrs. Ramirez in heart failure. Her condition eventually became so grave that she needed a heart transplant.

Heart failure is a condition that occurs when a heart cannot pump enough blood and oxygen to meet the body’s needs. Deaths because of this Climbing constantly throughout the country Earlier declines since 2012. The augment in metabolic disorders such as obesity, diabetes and high blood pressure contribute.

There are medicines for the treatment of one of the two main types of heart failure, but they are not used as much as they shouldThe doctors said. “Treatments that have been proven at work are not prescribed to people in a timely manner,” said Dr. Janet Wright, director of Division for Heart Disease and Stroke Prevention at the Center for Disease Control and Prevention.

But the growing awareness of the state and its risk factors can change this. And up-to-date treatment of another form of heart failure can also change the trajectory in patients with the disease.

What is heart failure?

There are two main types. The first type is the one that Mrs. Ramirez experienced, known as heart failure with a reduced ejection fraction, in which the heart muscle is delicate and does not squeeze as much blood as it should. However, in heart failure with the preserved ejection fraction, the heart squeezes normally, but the muscle is stiff and cannot relax.

People with heart failure often experience shortness of breath, fatigue and swelling of the legs and feet. They can be hospitalized many times and have about a 50 percent chance of life five years after the first hospitalization.

Studies estimate that half of patients with heart failure have a kind of preserved ejection fraction and become more common, because chronic diseases make them more common, said Dr. Chiadi Ndumele, director of the program of preventing heart failure at Johns Hopkins University.

What causes it?

High blood pressure is the main cause of heart failure, just like blocked arteries. High blood pressure increases heart load, while blocked arteries prevent the needed oxygen prevents.

Other risk factors are much the same as in the case of a heart attack and stroke, including obesity, diabetes and kidney disease.

Alcohol, as well as drugs such as cocaine and methamphetamine, can also be toxic to the heart and augment the risk of heart failure, said Dr. Michelle Kittleson, a professor of cardiology at the Smidt Heart Institute at Cedars-Sinai in Los Angeles. There are some additional risk factors specific to women, including menopause before 45 years and high blood pressure during pregnancy, said Dr. Sadiya Khan, preventive cardiologist at the Feinberg School of Medicine at Northwestern University.

What drives an augment in the number of deaths from the heart?

Doctors say that greater awareness and better diagnosis of heart failure can contribute to some of the documented augment in death.

Deaths are also partly the result of medical successes: people live longer and more people experience heart attacks. Heart failure is becoming more and more common with age, and heart attacks leave heart muscle injuries.

But the greatest factor, according to doctors, is probably an augment in metabolic risk factors, such as obesity and diabetes-and in patients with increasing ones. In 2021 it was almost 48 Deaths due to heart failure at 100,000 people At the age of 45 to 64, compared to 32 in 2012, death rates among men, black and people living in rural areas, southern and Central -Western United States also increased rapidly. Dr. Kittleson said that some of these trends reflect the disproportionate burden of heart failure suffered by sensitive populations. For example, black Americans more often than white people will develop high blood pressure and complications, such as advanced kidney disease and heart failure.

What treatments are available?

Dr. Kittlesson said that the treatment of heart failure with a reduced ejection fraction is a “triumph” of medicine. Scientists have discovered paths at work in illness, which led to therapy that make patients feel better, live longer and stay away from the hospital. These include drugs that reduce heart load, reduce blood pressure, lend a hand the body get rid of greater sodium and water and reduce blood glucose.

But the attempt to treat heart failure with the preserved ejection fraction was “extremely sobering,” said Dr. Kittleson. Efforts aimed at using treatments that clearly acted with a different form of heart failure, often failed. However, over the past five years, scientists have shown that drugs called sodium-glucose 2 (SGLT2) inhibitors can Reduce the number of deaths in patients with heart failure With preserved ejection fraction.

Last year, a huge clinical trial proved that the drug called Finerenone can Reduce hospitalizations in the field of heart failure and death.

And recent studies have shown that in patients with obesity and heart failure, semaglutide and thiropathy slimming drugs may Reduce events related to heart failure AND to correct How far people with this state can go.

Fresh therapies can potentially transform the landscape of treatment of heart failure. But for now these drugs remain “incredibly pricey and out of reach for most people,” said Dr. Khan. General versions that reduce costs are not yet available, and obtaining insurance approval can be complex.

People who face social conditions that negatively affect their health – such as poverty, lack of access to education, unemployment and uncertainty of food – more often have obesity and diabetes. It is more likely that they are experiencing complications from these conditions, such as heart failure, “because of the smaller early diagnosis, less optimal self -care and less involvement in the healthcare system,” said Dr. Ndumele. And there are higher chances that they do not have comprehensive insurance that would give them access to life -saving drugs.

“We have made extraordinary progress in how we can treat, but now we have to make a complex part that is affordable, accessible and fair,” said Dr. Khan.