Weight Gain Linked to Heart Failure Admissions

< Sep. 12, 2007 > -- Short-term weight gain can signal worsening outcomes for heart failure patients, a new study shows.

Patients who gain as little as two pounds over the course of a few weeks or less may require hospitalization within the month, according to heart researchers. Changes in weight may be related to fluid build-up that occurs as a result of heart failure.

Heart failure occurs when the heart cannot pump enough blood to meet the body's needs. Coronary artery disease, high blood pressure, scarring from previous heart attacks, and heart defects can all lead to heart failure.

Heart failure patients who gain over 10 pounds are eight times more likely than heart failure patients with stable weights to need hospitalization.

The study, published in Circulation, suggests that patients and their doctors may have several days or even weeks to control weight gain and avoid hospitalizations.

Weight Gain Precedes Readmission

The Yale University research team analyzed weight data and hospitalization records from 268 heart failure patients who were weighing themselves daily as part of a disease management program. The average age of the patients was 74. The researchers compared the data from half of the patients who were hospitalized with the half who were not.

The analysis showed that the hospitalized patients had gained more weight than their peers in the month before hospitalization. In the week just prior to hospitalization, weight increased rapidly. For heart failure patients, a rapid increase in weight can be due to fluid retention.

According to the Heart Failure Society of America, fluid retention is a common problem among people who have heart failure and can be treated with medication and dietary changes to help get rid of excess fluid and the associated pounds.

Timing is Everything

Doctors have known for some time that weight increase may be a sign of worsening heart failure, but the impact of the timing and amount of weight gain on hospitalization has not been studied before, the researchers say.

"We found that even small amounts of weight gain - as small as just over two pounds - predict hospitalization," lead author Dr. Sarwat Chaudhry, assistant professor of medicine at Yale University School of Medicine in New Haven, Conn., says. "We found that weight gain starts well before hospitalization, giving doctors and patients at least a few days to take steps to avoid the need for hospitalization."

Weight Gain Correlates Strongly with Admission Rate

People who gained an average of two to five pounds in the week before hospitalization were almost 3 times more likely to need hospitalization than heart failure patients with stable weight. Those who gained five to 10 pounds were 4.5 times more likely to need hospitalization, and those who gained over 10 pounds were almost eight times more likely to require hospitalization for heart failure.

"Heart failure is the most common reason for hospitalization among Americans, and more Medicare dollars are spent for heart failure than for any other diagnosis," Dr. Chaudhry says. "Our data suggest that a simple bathroom scale could empower patients in managing their own disease and alert their physicians to early signs of heart failure decompensation (the failure of the heart to maintain adequate blood circulation). Ultimately, our data may help change the standard of care to prevent patients from being hospitalized, improve their quality of life, and save precious health care resources."

Always consult your physician for more information.

Warning Signs

According to the American Heart Association, if you or a family member have heart failure, chances are you have already made a trip to the emergency room, or at least spent some time in the hospital. You can decrease the chances of another hospital stay by getting in touch with your doctor right away if any of these warning signs appear:

• Sudden weight gain (three or more pounds in one day, five or more pounds in one week, or whatever amount you were told to report)

• Shortness of breath not related to exercise or exertion

• Increases in swelling of the lower limbs (legs or ankles)

• Swelling or pain in the abdomen

• Trouble sleeping (waking up short of breath, using more pillows)

• Frequent dry, hacking cough

• Increased fatigue

If caught early, these symptoms may just require an adjustment in medication, which often can be explained over the phone.

Post the phone numbers for the primary care physician and cardiologist by your telephone, along with a list of current medications, other medical conditions and allergies. That way you can get in touch quickly if the condition changes.

Always consult your physician for more information.