Symptoms of heart failure are often not recognized in time and are easily attributed to age, stress, or fatigue, and this syndrome is increasingly seen in younger people and as a result of early exposure to risk factors, untreated diseases, and modern lifestyles.
This was stated in an interview with "Vijesti" by a specialist in internal medicine and subspecialist in cardiology, Dr. Maja Miročević RotoloShe says that modern therapy, along with blood pressure and sugar regulation, a healthy lifestyle and diet, allows heart failure to become a controlled chronic disease, but only if treatment is started in a timely manner.
He also reminds that cardiovascular diseases in Montenegro account for about 50 percent of all deaths, which is significantly higher than the global and European average, which is why individuals and the healthcare system must work together on prevention and adopting healthy habits.
What is heart failure and what are the first symptoms?
Heart failure is a clinical syndrome in which the heart is unable to pump a sufficient amount of blood to meet the body's needs, either at rest or during exercise, leading to typical symptoms and/or signs, along with objective evidence of heart failure (laboratory, echocardiographic, etc.)
The first symptoms to look out for are: fatigue during activities that were not previously a problem, shortness of breath (initially during exertion, later also at rest or at night), swelling of the lower legs and ankles, rapid or irregular heartbeat, sudden weight gain (due to fluid retention), fatigue, decreased concentration. It is important to note that symptoms are often non-specific and are easily attributed to age, stress or fatigue.
Who is most at risk? Is it a disease of the elderly or does it affect younger people as well?
People with a combination of age, cardiovascular, and systemic risk factors are at greatest risk for heart failure. It is important to emphasize that heart failure is most often not a sudden event, but the final stage of long-term heart damage.
Heart failure is more common in older age, but it is not a disease only of older people.
Patients at greatest risk are those who have had a heart attack/coronary heart disease, people with arterial hypertension, diabetes, chronic kidney disease, obesity, people with sleep apnea, valve diseases, arrhythmias (such as atrial fibrillation), and cardiomyopathies, including genetic ones.
In younger people, heart failure often occurs due to myocarditis, congenital defects, peripartum cardiomyopathy (during pregnancy), toxic damage (e.g., alcohol, certain oncology therapies). However, heart failure is increasingly seen in younger people as a result of early exposure to risk factors, untreated diseases, and modern lifestyles. This is why prevention at a younger age is crucial.
How important is early diagnosis and what are the consequences if heart failure is not treated on time?
Early diagnosis is crucial, because heart failure progresses. If we start treatment later, there is a greater likelihood of frequent hospitalizations, progressive damage to the heart and other organs (kidneys, liver), and an increased risk of sudden cardiac death.
The important STRONG-HF study showed that early, intensive introduction and rapid optimization of therapy after an acute episode of heart failure, along with regular cardiological monitoring, improves outcomes, which is reflected in the latest updated recommendations for heart failure from the European Society of Cardiology.
Modern therapy today allows heart failure to become a controllable chronic disease, but only if treatment is started in a timely manner.
What role do lifestyle, diet, and physical activity play in the prevention and control of heart failure?
This is the “second pillar” of treatment with medication, because without it, the therapy has a weaker effect. The most important measures are: regulation of blood pressure and blood sugar, reduced salt intake, balanced diet (Mediterranean type of diet), regular, adapted physical activity, smoking cessation, body weight control, stress and sleep control. Alcohol is best avoided, and if consumed, it should be consumed in moderation. Physical activity, when properly dosed, improves the functional capacity of the heart, reduces symptoms and improves the psychophysical condition of the patient.
Cardiovascular diseases are responsible for about 50 percent of all deaths in Montenegro. How do you interpret this alarming figure and what are the causes of such a high mortality rate?
According to data from the World Health Organization, cardiovascular diseases cause about 32 to 33 percent of all deaths globally. In the European Union, this share ranges between 36 to 38 percent. Montenegro, with about 50 percent, deviates significantly upwards, placing itself in the group of countries with the highest relative cardiovascular mortality in Europe, similar to some countries in Eastern and Southeastern Europe.
In other words, mortality from cardiovascular diseases is a reflection of the overall health and social condition of a country.
The main causes of high mortality are: high incidence of risk factors (hypertension, smoking, obesity, dyslipidemia, diabetes), late reporting to a doctor, socioeconomic factors, stress, sedentary lifestyle, insufficient control of chronic diseases, weaker culture of preventive examinations in certain environments and the impact of air pollution, which is strongly associated with increased cardiovascular mortality.
What can the healthcare system do, and what must individuals do, to change this worrying trend?
The healthcare system must strengthen preventive programs, improve early diagnostics at the primary level, ensure the availability of modern therapy, invest in the education of healthcare workers and patients, and develop a multidisciplinary approach to treatment.
Individuals must take personal responsibility for their health. It is important to regularly monitor blood pressure, sugar and blood fats and not ignore symptoms. It is necessary to follow the advice of a doctor, take therapy regularly and come for check-ups, and it is especially important to adopt healthier lifestyle habits.
Bonus video:
