Diastolic heart failure

Posted by dancer1967 @dancer1967, Mar 31, 2017

I am a 72 yr old female. I have been diagnosed with diastolic heart failure, hardening of arorta.. I also have hypothyroid. My blood pressure had been high for yrs and cholesterol was very high. I had an echocardiogram three yrs ago and was never treated for heart failure till last yr when my EKG came back abnormal during a preop exam for hernia surgery. Now I take Lipitor,Carvedilol, My numbers have gone down, chol-133, HDL 125, LDL 62.
My dr doesn't seem to be concerned. I would like to know what other tests you recommend and are the medicines he is giving me sufficient?
Thank you

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Welcome to Mayo Connect @dancer1967. I'll give you some initial reactions and look for others to join us in the days ahead. Our diagnoses are similar. I have hypertension and elevated cholesterol along with atrial fibrillation and diastolic dysfunction. I take Carvedilol and a diuretic, along with Lisinopril, for blood pressure and Warfarin (Coumadin) for a-fib. My treatment program also relies on lifestyle improvements through exercise, nutrition, and entertainment.

I'm not a doctor or know enough about your situation, so I can't recommend either tests or treatments, but that's all to the good. Your doctor is the best hope of answering your questions, plus a few others I'd suggest. What BP readings are you taking daily? Mine are below 150 systolic and 88 diastolic, which are within the targets currently in effect for people over 70 years of age. Have you asked your doctor about medication for your hypothyroid condition? Is Lipitor still needed? I quit that two years ago because of side effects and rely on good nutrition to keep cholesterol at bay. Would you benefit from examination by a nephrologist? I benefited greatly from focusing on hypertension as a kidney-impacted condition.

I suspect your doctor's concern is measured and proper, much like his/her treatment so far. It might be useful to discuss your lifestyle choices with your doctor. Before that, take a look at this advice from the American Heart Association on how to live with heart failure: http://bit.ly/2ok3C41. Take advantage of the links in the right-hand column of that page to delve deeper into the information. And be sure to keep us posted on how you're doing and what progress you make managing your conditions and enjoying your life.

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Thank you. My BP is in 130/80 range. And I have been on thyroid meds for 30 yrs. I am just totally scared of the words heart failure and needed to hear from people like you. My family history is full of heart problems.

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I too was diagnosed with diastolic heart failure. I was also prescribed Carvedilol. I also take Diltiazem ,Hydralazine, and Triamterine for high blood pressure. I have taken Lipitor for years. I would love some expert info on this condition to make sure I am taking the right meds. My family also is loaded with heart issues.

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Welcome back @joyful556. Is your situation better defined now and more directly addressed by your medical team? I'm a little surprised that you are taking four different medications for hypertension. Were they prescribed by one physician? I hope s/he has been willing to explain to your satisfaction why the medications are needed and for how long you can expect to be taking them. Like many of my colleages at Mayo Connect, I don't have the kind of intimate knowledge of your diagnoses and can't provide you "expert info" on whether you are "taking the right meds." Would you feel comfortable asking for a second opinion from another physician with recognized experience in treating heart failure?

You mentioned heart issues in your family, and that leads me to think you'd be interested in how your inherited characteristics -- your genetics -- can lead you to better care and treatment. If you are interested, please ask your medical team about getting a genetic test under pharmacogenomics, a relatively new branch of medicine that detects and studies what medication(s) your unique body and metabolic system would prefer.

In the meantime, you might learn important information from the web site I recommended earlier today: http://bit.ly/2ok3C41. Check the sections before and after this one on the American Heart Association site for challenging information on heart failure and how to live it down! Keep us posted on your episodes in the days ahead.

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Thank you for your info. I also have diminishjed kidney function and the doctor was trying to keep my blood pressure as close to normal as possible for that condition along with the diastolic dysfunction. I have checked all the blood meds out and they all seem to help with the diastolic dysfunction. Could you tell me your concerns about taking the 4 meds? The doctor who prescribed them was the nephrologist who also consulted with the cardiologist. It is all very tricky. Thank you for any additional input you have.

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@joyful556

Thank you for your info. I also have diminishjed kidney function and the doctor was trying to keep my blood pressure as close to normal as possible for that condition along with the diastolic dysfunction. I have checked all the blood meds out and they all seem to help with the diastolic dysfunction. Could you tell me your concerns about taking the 4 meds? The doctor who prescribed them was the nephrologist who also consulted with the cardiologist. It is all very tricky. Thank you for any additional input you have.

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@joyful556, it's good to hear that a nephrologist is on your medical team. Same for me, and it's been most fortunate. Mine is the daughter of the leading cardiologist in the state of her birth, so she has a strong background for her work on me.

While I'm surprised at your four hypertension meds, I don't question them, especially since they are the offerings of a nephrologist who is in consultation with a cardiologist. My observation was conditioned by the fact that, in over 25 years of treatment for hypertension and chronic kidney disease, I have been treated with over two dozen different medications -- most of which were ruled out within a few weeks or months, but some of which stayed around too long, because my doctors assumed my "essential hypertension" could not be fixed. Ultimately, my nephrologist discovered a genetic problem was at the root of my potassium deficiency, and that unexpected development firmed up the foundation of my treatment.

Your four meds interact in your body, and your doctors may very well see the need for them all. Hopefully, your doctors have been the main source of information on the meds, their interactions, their side effects, the dosages you need, and the results you can expect from taking them. Since the current ceiling on blood pressure for people over 70 is 150 systolic and 90 diastolic, perhaps your doctors would explain whether your 130/80 might reflect somewhat excess medication. With answers to these questions, you'll be better able to understand why your doctors don't seem especially concerned about your current status.

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I have been diagnosed with grade 1 diastolic dysfunction by echo just last month. It also states I have aortic sclerosis with mildly dilated atrium. Under tricuspid valve it states mild pulmonary hypertension. I also have cirrhosis of the liver with portal hypertension. Do these two conditions go together and how does one affect the other? I would appreciate your input if you have knowledge of this. Thank you in advance. Molly B.

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