As the 2013 World Salt Awareness Week calls for “Less Salt, Please”, it may be time for Europeans to seriously consider the implications of their seasoning habits on their health, notably their heart health.
Heart failure (HF) is characterised by the inability of the heart to respond to the blood flow demands of the body, a condition that is becoming increasingly common, with more than 20 million directly affected worldwide. The overall prevalence of HF is increasing because of an ageing population, prolonged survival in patients suffering from coronary events, and effective prevention in those at high risk or those who have already survived a first event. In addition to a high prevalence, HF is also a deadly and costly disorder, carrying an overall prognosis that is worse than with cancer. The signs and symptoms of HF include fluid overload, tachycardia, shortness of breath, and chest pain. The symptoms are not specific for HF and diagnosis in an emergency situation can be difficult. Electrocardiography (ECG), chest X-ray, echocardiography and use of biological markers (or biomarkers) are thus recommended as the most practicable ways of assessing cardiac function.
The use of “markers” in the blood for diagnosis of patients admitted to the emergency room with suspected HF is constantly increasing and is now part of routine practice in industrialised countries. Most of the biomarkers used for diagnosis and prognosis derive from the neurohormonal response to the failing myocardium, which in the case of HF are specifically focused on assessing the presence of natriuretic peptides – in vitro diagnostic (IVD) blockbusters used in routine clinical and laboratory practice.
Emerging biomarkers represent potential new tools with added value for monitoring of HF patients and identification of patients at increased risk. Expectations are also being placed on their ability to support guided treatment, to allow more tailored therapies and monitor the safety and efficiency of medical devices. The pressure for biomarkers is on.
As the sector continues to develop, the quality of life for patients with chronic cardiovascular conditions may improve and those who are identified as at risk for HF, diminishing the impact of risk factors, such as high blood pressure, is a primary step. A diet rich in sodium, responsible for high blood pressure and increased risk for stroke, HF and other cardiovascular problems, is perhaps the easiest point of attack. By cutting down on the amount of sodium consumed, blood pressure medication may improve in effectiveness and patients who have already suffered from a heart condition can limit their chances of a reoccurrence.
Emerging biomarkers for heart failure identification are stimulating the medical community and enhancing the management of HF patients. Laboratory technicians, IVD manufacturers and physicians will have to make joint efforts to provide broad spectrum validation and confirm the potential added value of innovative biomarkers in heart failure. Patients, on the other hand, will have to take it upon themselves to also consider their diet and its relationship to cardiovascular health problems.
– Damien Gruson, Head, Department of Laboratory Medicine, St-Luc University Hospital
