Lifestyle & heart failure
by David Dunaief
Oct 31, 2018 | 7416 views | 0 0 comments | 630 630 recommendations | email to a friend | print
Dr. David Dunaief is located in Downtown Brooklyn and focuses on the integration of medicine, nutrition, fitness and stress management.
Dr. David Dunaief is located in Downtown Brooklyn and focuses on the integration of medicine, nutrition, fitness and stress management.
Chronic heart failure tends to be overlooked by the press. Heart failure occurs in about 20 percent of the population over the age of 40.

Heart failure (HF) occurs when the heart’s pumping is not able to keep up with the body’s demands and may decompensate. There are two types, systolic heart failure and diastolic heart failure.

The basic difference is that the ejection fraction, the output of blood with each contraction of the left ventricle of the heart, is more or less preserved in diastolic HF, while it can be significantly reduced in systolic HF.

Both types can be diagnosed with the help of an echocardiogram, an ultrasound of the heart. The signs and symptoms may be similar and include shortness of breath on exertion or when lying down; edema or swelling; reduced exercise tolerance; weakness and fatigue.

Risk factors for heart failure include diabetes, coronary artery disease, high blood pressure, obesity, smoking, heart attacks and valvular disease.

Typically, heart failure is treated with blood pressure medications, such as beta blockers, ACE inhibitors and angiotensin receptor blockers.

We are going to look at how diet, iron and the supplement CoQ10 impact heart failure.

Effect of diet

Oxidative stress may play an important role as a contributor to HF. It is thought to potentially result in damage to the inner lining of the blood vessels, or endothelium, oxidation of cholesterol molecules, and a decrease in nitric oxide, which helps vasodilate blood vessels.

In the Swedish Mammography Cohort study, results show that a diet rich in antioxidants reduces the risk of developing HF. In the group that consumed the most nutrient-dense foods, there was a significant 42 percent reduction in the development of HF, compared to the group that consumed the least.

The antioxidants were derived mainly from fruits, vegetables, whole grains, coffee and chocolate. Fruits and vegetables were responsible for the majority of the effect.

CoQ10 supplementation

Coenzyme Q10 is a substance produced by the body that helps the mitochondria (the powerhouse of the cell) produce energy. It is thought of as an antioxidant.

A randomized control trial of 420 patients with severe HF showed an almost 50 percent reduction in the risk of all-cause mortality and 50 percent fewer cardiac events with CoQ10 supplementation.

The lead author goes as far as to suggest that CoQ10 should be part of the paradigm of treatment. He may be a bit enthusiastic, but this is the first new “drug” in over a decade to show survival benefits.

Like some other supplements, CoQ10 has potential benefits, but more study is needed.

Iron Deficiency

Iron deficiency can occur without anemia. An observational study, published in the American Heart Journal, followed 753 heart failure patients for almost two years showed that iron deficiency without anemia increased the risk of mortality in heart failure patients by 42 percent.

The authors concluded that iron deficiency is potentially more predictive of clinical outcomes than anemia, contributes to the severity of HF, and is common in these patients.

It behooves us to try to prevent heart failure through dietary changes, including high levels of antioxidants, because it is not easy to reverse the disease. Those with HF should have their ferritin levels checked, for these are correctable.

I am not typically a supplement advocate; however, CoQ10 seems like a compelling therapy to reduce risk of further complications and potentially death. Consult with your doctor before taking CoQ10 or any other supplements, especially if you have heart failure.

For further information, visit or consult your personal physician.

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