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Diabetes Mellitus has taken a shape of an epidemic not only in developed countries but in developing countries too due to growth of fast food chains, which promoted sedentary life style, that resulted in increased incidence of diabetes mellitus and heart diseases in the developing countries. This was stated by Dr Sheikh Aftab Iqbal, president and Dr Sheharyar Bhatti, secretary general, Pakistan Society of Family Physicians (PSFP) while talking to Business Recorder here on Thursday.
Talking about treatment for acute de-compensated heart failure, they stated that heart failure remains a highly fatal disease. "Almost 50 percent of heart failure patients die within five years. With the availability of more effective drugs and increase in life expectancy now heart failure patients live longer.
After 20 years, heart patients over 65-year of age will be doubled. Heart failure is emerging as an entity, which has drawn attention and now many hospitals have special heart failure units. Many new devices have also become available for heart failure", they said.
Currently, they stated that the incidence of heart failure is increasing due to unhealthy lifestyle. Up to 60s, there is male preponderance but after the age of 74-year, there is no difference in heart failure risk among male and female.
Continuing they said that about 40 percent heart failure patients die due to sudden death. In many cases heart failure is not appropriately treated during hospitalisation, they said; adding heart failure management guidelines are not followed.
Talking about the pathophysiology of heart failure, they said that 50 percent of these patients do not have systolic dysfunction. They stated that high-risk patients include those suffering from hypertension, coronary artery disease, diabetes, besides family history of cardiomyopathy.
About heart failure therapy they suggested treatment of hypertension, correcting lipid abnormalities, stopping smoking and use of ACE inhibitors and ARBs besides other pharmacological agents. Use of ACE inhibitors, ARBs certainly influences survival.
Responding to a question, they said that cardiac transplant is not the answer because we do not have enough donors. Use of drugs improves survival, decrease risk of new cardiac injury.

Copyright Business Recorder, 2005

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