Heart failure: Doing what your doctor says works

Doctors have been dispensing advice to heart failure patients and for the first time researchers have found that it works. While self-care is believed to improve heart failure outcomes, a highlight of the recent American Heart Association scientific statement on promoting heart failure self-care was the need to establish the mechanisms by which self-care may influence neurohormonal, inflammatory, and hemodynamic function.

Christopher S. Lee, PhD, RN of the Oregon Health & Science University School of Nursing led a team of researchers who examined the biological mechanisms by which self-care influences heart failure outcomes. The findings are published in the July/August issue of the Journal of Cardiovascular Nursing.

“To the best of our knowledge, this is the first clinical investigation of the relationship between participant reported self-care and serum biomarkers of myocardial stress and systemic inflammation in persons with heart failure,” explains study co-author Barbara J. Riegel, a professor at Penn Nursing.

This study investigated the relationship between heart failure patients who complied with self-care plans and serum biomarkers of myocardial stress and systemic inflammation. Heart failure patients who followed doctor’s advice for self-care (such as taking medications, monitoring and interpreting symptoms, eating a low-sodium diet, and exercising) showed lower levels of myocardial stress and systemic inflammation, thought to be associated with greater risk of mortality, urgent ventricular assist device implantation, and urgent heart transplantation.

Nancy C. Tkacs, an associate professor at Penn Nursing, also participated in this first study which strongly suggests the decision-making process of self-care management be measured and included as a determinant of heart failure biomarkers and health outcomes in future research.

The researchers conclude evaluating, teaching, and promoting effective self-care behaviors in persons with heart failure influences health outcomes through multiple cardioprotective means, and may decrease myocardial stress and systemic inflammation.

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