Monitor congestive heart failure closely

Katherine Klingle

By Katherine Klingle

According to the National Institutes of Health, more than 5 million people in the U.S. have congestive heart failure, contributing to 300,000 deaths each year. Congestive heart failure is sometimes caused by high blood pressure, coronary artery disease and diabetes, although drug abuse and congenital heart disease are other examples of causes. The word "failure" does not mean that your heart has stopped working, but that the heart has weakened and is not able to pump with enough force or that the heart is not filling with enough blood to pump. It is a serious condition that deserves close monitoring by your primary care provider. Some symptoms may be shortness of breath, swelling in the legs, feet and ankles, along with decreased energy. However, as is true in many diagnoses, there is a lot you can do to manage and minimize its effects on your daily life as well as reduce the number of hospital visits that may occur.

In the hospital setting, we often use the phrase "know your numbers." This is certainly applicable with congestive heart failure.

The first number you should know is your usual weight. It goes without saying that maintaining a normal weight in general reduces your risk for heart disease, as well as many other diseases. However, daily weights will help you track a trend of weight gain which may be because of fluid. Keep a pencil and paper in your bathroom and weigh yourself every morning after urinating and before drinking anything. Generally, avoid gaining two pounds of weight gain or five pounds of weight gain per week, though you should discuss acceptable fluctuations with your PCP. You may need to adjust your fluid intake, according to the results of the scale. Approximately two cups of any fluid is equal to one pound.

The second number represents milligrams of sodium per day you should limit your dietary intake to. Historically, a good goal has been a limit of 2,000 mg sodium per day although the American Heart Association is now recommending 1,500 mg per day for most people. Sodium is a natural component of food and water, but a lot of the food we eat has sodium added. Learn to check labels. It may shock you to see how much sodium is in food that doesn't even taste salty. It's the combination of sodium and chloride that create the salty taste, and sodium alone does not taste salty. Choosing more fresh, natural, unprocessed fruits, vegetables, lean protein sources, dried beans, fat-free dairy and grains provide an abundance of nutrients, fiber and minimal sodium.

The third is a group of numbers we all should know - blood pressure, cholesterol and glucose levels. Elevations in these also put a strain on your heart. Check with your PCP for his or her recommendations.

If you have congestive heart failure, there is much you can do to manage it. There are reputable online sources available for further information such as www.nhlbi.nih.gov or www.americanheart.org or contact your local registered dietitian.

Katherine Klingle is a Registered and Licensed Dietitian. Send questions or comments to dietitians@vicad.com.