Understanding pre-heart failure; breaking the cycle of depression

Q: My doctor says I have pre-heart failure. What is that exactly and how can I prevent complete heart failure? -- Glen G., Grosse Pointe, Michigan

A: A report from the Heart Failure Society of America reveals that 24% to 34% of U.S. adults have pre-heart failure. And many of those folks go on to develop heart failure. In fact, they caution that soon the lifetime risk of heart failure may hit 24%, meaning that one in four adults will develop the condition.

Heart failure, AKA congestive heart failure, is a progressive condition that happens when your heart doesn't fill up with enough blood or is too weak to effectively pump out blood to supply the rest of your body with what it needs to function properly. As a result, blood and fluid build up in your lungs, legs and feet. Breathing is compromised. Kidney and liver function are impaired.

It can be caused by high blood pressure, coronary heart disease, obesity or cardiomyopathy -- the thickening, stiffening and/or enlargement of your heart muscle. It results in gradual worsening of your overall health, because your blood isn't able to supply your body with enough oxygen and nutrients or keep organ systems working properly.

Pre-heart failure, also called asymptomatic left ventricular dysfunction (ALVD), means you have evidence of left-ventricular dysfunction and or left-ventricular hypertrophy (enlargement and thickening of that area of the heart), but no outward symptoms of heart failure.

There are many ways to support your heart health and help control pre-heart failure. They include taking antihypertensive ACE inhibitors, beta blockers and statins. And for folks with electrical disturbances of their heart rhythm, automatic implantable cardioverter defibrillators and biventricular pacemakers may be helpful. In addition, adopting healthy lifestyle habits, including not smoking, getting doctor-supervised physical activity, eating a plant-based diet and managing stress, can provide major benefits. You're lucky you got this early diagnosis; take advantage of the opportunity to improve your longevity -- and for more heart-loving choices, check out LongevityPlaybook.com.

Q: So many of my friends -- and their teenage kids -- are depressed. It's depressing me! What can we do to break out of this cycle? -- Sheryl J., Providence, Rhode Island

A: You're right. There's an epidemic of the blues and of more serious chronic depression permeating every corner of the country. A recent study in JAMA Pediatrics found that in 2021, 20% of adolescents were contending with a major depressive disorder -- and less than half of them received treatment. And an ongoing Gallup poll on depression in America reports that this year, almost 18% of adults are being treated for depression and almost 30% have received treatment at some point over their lifetime. That's a 7% increase since 2015. And a truly upsetting statistic from the Centers for Disease Control and Prevention shows that the suicide rate in 2022 was the highest ever recorded -- up 16% since 2011.

The physical repercussions of mild and chronic depression are far-reaching, including poor stress management, dementia, obesity, premature heart disease and high blood pressure, sleep disorders, disrupted relationships, and an increased risk of cancer and decreased effectiveness of cancer medication.

Kids and adults need support and treatment to manage or shed their depression. That includes talk therapy, medication (for some), and a wide variety of self-help habits including interacting with your posse of friends and family, finding a passion, getting physical activity (150-300 minutes a week), and enjoying yoga, meditation, moderate-to-no alcohol consumption, and identifying what you have to be grateful for. One more important self-help technique: improved nutrition. A major study in JAMA Network Open found that eating highly processed foods is directly related to an increased risk for depression. Especially risky? Artificial sweeteners and artificially sweetened beverages; they seem to cause brain changes that lead to depression!

If you or your child is contending with depression, don't shy away from talking about it, reaching out to your doctor for advice, seeking treatment and upgrading your daily habits to support a happier healthier future.

Health pioneer Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. Check out his latest, "The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow," and find out more at longevityplaybook.com. Email your health and wellness questions to Dr. Mike at [email protected].

King Features Syndicate

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