While death rates from heart attack and stroke are declining, the death rate from congestive heart failure is rising. That's because the disease mainly affects older adults and more people are living long enough to develop it. In addition, people are surviving other medical problems, such as heart attacks, which increase the risk for congestive heart failure.
However, advances in treatment may help people with the disease live longer, according to the July issue of "Mayo Clinic Health Letter" (1-800-333-9037). With congestive heart failure, the heart can't pump enough blood to meet the body's needs. Less blood leaves the heart, and the blood returning to the heart backs up. As back pressure builds, fluid from the blood can collect in vital organs, including the lungs and liver. Fluid also can seep into surrounding tissues, causing swelling.
Congestive heart failure is often the result of other cardiovascular problems, and treatment may focus on these problems. However, many times underlying causes cannot be corrected. Then treatment focuses on preventing further damage. The following medications may help:
• ACE (angiotensin-converting enzyme) inhibitors
These drugs are the mainstay treatment for the condition and are the only ones clearly proven to help.
Often referred to as water pills, diuretics make urination occur more often and keep fluid from collecting in the body.
Also known as digitalis, it increases the strength of heart muscle contractions. It reduces heart failure symptoms, but doesn't improve survival rates.
• Beta blockers
These medications may improve blood flow.
Another treatment option is a heart transplant. Survival and quality of life after a transplant are excellent, but there is a shortage of donor hearts. Transplant candidates are typically under age 65, have no other life-threatening disease and their other vital organs are healthy.
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Activity helpful for "frozen shoulder"
"Frozen shoulder," also called adhesive capsulitis, is a painful condition that can make the shoulder stiff and sore, with a burning ache. The condition usually gets better on its own; the cause of of this condition is not known, but the immune system or an injury may be involved. Recommended treatment is gentle stretching and non-steroidal, anti-inflammatory drugs to relieve pain.
If severe stiffness is persistent, gentle manipulation of the shoulder under an anesthetic may help recovery. Very rarely, arthroscopic surgery may be recommended. Other treatments include steroid injections and physical therapy soon after the problem is diagnosed.
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Coffee Not So Bad
Caffeine provides the kick in coffee, and drinking too much of it can have noticeable effects. But so far the research hasn't proven any links between drinking coffee in moderation and serious health problems. Here's what is known:
• There is a limited association between cancer and coffee, found only at very high levels of coffee consumption.
• Coffee compounds that have been linked to increased cholesterol levels aren't found in filtered or instant coffee, which most Americans drink.
• Caffeine can intensify certain heart rhythm problems, and cause a temporary rise in blood pressure.
• Caffeine increases the amount of calcium excreted in urine, but only with a large intake of caffeine does risk of osteoporosis increase.