Did you know 1 in every 5 Americans will develop heart failure?
Heart failure — a potentially life-threatening condition in which the heart essentially fails to pump enough blood and oxygen throughout the body — is on the rise. According to a report published by the American Heart Association, the number of people with heart failure has increased over the past decade and will likely jump by nearly 50 percent to more than 8 million people in 2030.
So, what causes heart failure?
Many conditions, including high blood pressure, coronary artery disease, heart disease and abnormal heart valves, automatically increase a person’s risk for developing heart failure, but so can certain medications. “There are medications that may cause heart failure, and medications that increase the risk of developing heart failure,” says Dr. Radmas Pai, a clinical professor at the University of California-Riverside School of Medicine. Here are six examples that can cause or contribute to heart failure:
Pain medications
Nonsteroidal anti-inflammatory medications such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naproxen) and cyclogenase-2 (or COX-2) inhibitors (celecoxib, Celebrex) can cause the body to retain sodium. Excess sodium in the body makes the body retain more fluid, forcing your heart to work harder. This can be a major problem for people who already have heart failure. “One thing many people don’t think about is painkillers — NSAIDs,” Pai says. But he says the risk is “potentially preventable” if doctors have more conversations with their patients about these drugs.
Diabetes medications
Avandia (rosiglitazone) belongs to a group of medications for diabetes called thiazolidinediones, or TZDs, and was the first drug of its kind to make headlines for increasing the risk of heart failure. In 2011, the Food and Drug Administration restricted Avandia to people with diabetes that wasn’t well-controlled by other medications. In 2013, a comparable drug, pioglitazone (Actos), got a similar regulation. Both drugs can cause fluid retention, putting stress on your heart, and received “black box” warnings for their potential to cause or worsen congestive heart failure.
Sodium
Although not technically a drug, Pai calls sodium a “silent killer for the heart and the kidney.” That’s because not only do certain medications increase sodium and water retention, but many medications also contain sodium as an inactive ingredient. Dr. Andrew Civitello, an assistant professor of medicine and medical director of the Heart Transplant Program at Baylor College of Medicine, warns this can spell trouble for patients in hospitals. “It’s more of a problem in the hospital because many of the medications are mixed with a fair amount of salt water solution,” he says. Some over-the-counter drugs also contain high amounts of sodium, like the OTC laxative Fleet Phospho-Soda, which contains 2 grams of sodium — almost the entire amount of the 2.3-gram maximum recommended by the AHA.
Chemotherapy
You probably already know many medications used in chemotherapy can have unpleasant side effects, such as severe nausea and vomiting, hair loss and kidney damage. But some drugs used to fight cancer can strain the heart, too. Older cancer drugs like cyclophosphamide (Cytoxan) and doxorubicin, which are used in cancers such as leukemia, are known to weaken the heart muscle. Doxorubicin has a “black box” warning because it can cause congestive heart failure months or years after stopping treatment.
Pai says trastuzumab (Herceptin), a newer cancer medication commonly used in breast cancer and some stomach cancers, causes inflammation in the heart muscle and reduces its ability to pump blood effectively. The solution: “People with cancer should be monitored early,” Pai says. “Is the drug worth the risk? A lot of times you don’t have an option because you need to cure cancer, but it’s a balancing act.”
Certain drugs for irregular heartbeat
Sotalol (Betapace, Betapace AF) falls into two drug categories: It’s technically a beta blocker, meaning it acts on receptors on the heart and encourages the heart rate to slow down. But sotalol also helps reduce overactivity in the heart cells that lead to irregular heartbeat. This feature can make things very difficult for a heart that’s already failing to pump blood and oxygen adequately throughout the body. Flecainide is another medication that helps control irregular heartbeat in a similar way, and experts say it’s not a good option for heart failure, either.
Calcium channel blockers
There are many different medications in this class, but two are absolute no-nos for people who have heart failure or are already at risk. “Verapamil (Calan, Calan SR, Covera-SR, Verelan) and diltiazem (Cardizem, Cardizem CD, Cardizem LA, Dilt-CD, Diltzac, Taztia XT, Tiazac) reduce the contractility of the heart,” Pai says. “This can make the heart function weaker if you already have heart problems.”
Salt substitutes
Experts recommend avoiding them when you’re trying to reduce your sodium intake. “We ask our patients not to use salt substitutes because many of them are very high in potassium,” Civitello says. “You can get hyperkalemia, which is too much potassium in your bloodstream, and it can cause your heart to stop.” The same goes for over-the-counter supplements. “People really need to understand that there is no proven benefit in over-the-counter supplements over medications, and they should discuss these things with their doctors because they are not all benign,” Civitello says.
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6 Drugs That Can Worsen or Increase Risk for Heart Failure originally appeared on usnews.com
