Chronic Heart Failure

Abstract

Death by heart failure (HF) is a terrible long agony that does not spare celebrities. Poets who wrote about broken hearts, from Samuel Taylor Coleridge to Robert Frost, Edgar Allan Poe, and Pablo Neruda, and Hollywood stars who played on the stage or created characters experiencing heartache from Barbara Stanwyck to Bing Crosby, Alfred Hitchcock, and Elizabeth Taylor died of chronic heart disease. The beautiful description of the sadness of love by Tagore,1 perhaps the greatest writer in modern Indian literature, evokes the dramatic experience of patients with advanced HF and pulmonary edema: Rabindranath Tagore was a poet, philosopher, artist, playwright, composer, and novelist. Tagore was India’s first Nobel laureate; he won the Nobel Prize for Literature in 1913. In the past 3 decades, HF has reached endemic proportion in the industrialized world, with 5.1 million patients affected by this syndrome in the United States alone where there is an annual incidence of 670 000 new cases, almost equally distributed between men and women.2 Data from Europe are similarly striking,3 and Asia is experiencing a dramatic increase in the critical risk factors for HF, projecting a worrisome perspective of the social, economical, and medical impact that this disease will have in this continent in the forthcoming future. The unexpected enormous economic growth in China, unmatched by any other country in Asia, has resulted in an increase in life expectancy and in major changes in the lifestyle of the population.4 However, Westernized customs come with a price and cardiovascular disease has now become the leading cause of death in China.4 Currently, 230 million Chinese experience cardiovascular disease; 200 million have hypertension, 7 million have a history of a previous cerebral ischemic event, and …