Explore the relationship between heart failure progression and weight gain, along with tips for managing both.
Weight gain is frequently observed in individuals with heart failure. This phenomenon arises from the heart’s inability to effectively pump blood, leading to diminished circulation. Reduced blood flow through the kidneys can result in the accumulation of excess fluid in the body, contributing to weight gain. Dr. C Raghu, Clinical Director and Senior Interventional Cardiologist at Yashoda Hospitals in Hyderabad, sheds light on the correlation between heart failure and weight gain.
Dr. Raghu explains that heart failure is characterized by the heart’s inability to circulate blood effectively. Contrary to its alarming name, it typically involves a gradual deterioration in heart function rather than an abrupt event. Heart failure is not a standalone disease; rather, it manifests as a constellation of symptoms stemming from various underlying conditions such as heart attack, high blood pressure, aging, obesity, heart valve issues, and diabetes.
Challenges in Circulating Blood with Heart Failure
Heart failure presents two primary challenges to circulation:
- Inadequate oxygen supply to organs: This can manifest as fatigue, mental confusion, and pale skin.
- Fluid accumulation in various organs: Resulting in symptoms such as weight gain, shortness of breath, coughing, wheezing, loss of appetite, and swelling in the legs, feet, and abdomen.
The Process of Weight Increase in Heart Failure
“Impaired heart function results in decreased blood pressure and diminished blood supply to the kidneys, triggering a hormonal response,” explained Dr. Raghu. “This hormonal imbalance leads to retention of salt and water, ultimately causing weight gain.”
“Weight gain typically occurs gradually, with swelling becoming noticeable only in later stages,” Dr. Raghu continued. “It takes the accumulation of at least five liters of water before foot swelling occurs, and by the time patients seek medical attention, they may have retained nearly 20 liters of fluid. Surprisingly, even with such significant fluid buildup, patients may not experience noticeable symptoms.”
Dr. Raghu emphasized that weight gain in heart failure is indicative of poorer outcomes, including the need for hospitalization, sudden death, and abnormal heart rhythms. A study conducted in 2023 found that both weight gain (approximately 4.5 kg) and weight loss (approximately 8 kg), known as cardiac cachexia, were associated with adverse outcomes.
Monitoring and Addressing Weight Gain in Heart Failure
Weight gain necessitates meticulous daily weight tracking. An increase of one kilogram over three days or two kilograms over one week is deemed noteworthy.
Dr. Raghu emphasized, “Although weight gain and weight monitoring haven’t proven to reduce the likelihood of hospitalization or mortality, it’s customary for physicians to advise patients to monitor their weight daily. They may also recommend medications that enhance urine output and advocate for reduced salt intake in cases of significant weight gain.”
Fluid restriction is advised for heart failure patients to prevent excessive fluid retention. Typically, heart failure patients are encouraged to consume 1.5-2.0 liters of fluid per day, as overly strict fluid restriction can exacerbate kidney function decline.
Strategies for Managing Weight Gain in Heart Failure
Dr. Raghu outlined several steps to address weight gain in heart failure:
- Daily Weight Monitoring
- Participation in Exercise Programs and Training, such as Cardiac Rehabilitation
- Adherence to Medication Regimens
- Adoption of Heart-Healthy Diets and Nutritional Plans
- Management of Cardiac Risk Factors, such as Diabetes and Hypertension
Bottomline
Dr. Raghu concluded, stating, “Heart failure encompasses a range of symptoms, with weight gain being a prominent indicator of deteriorating health. Early intervention in addressing weight gain can lead to improved symptom management. Patient education regarding weight management is crucial in preventing the progression of heart failure. Medications and lifestyle adjustments are vital components in effectively managing weight gain associated with heart failure.”