Lack of appetite worsens the course of existing heart failure

Health risk: loss of appetite worsens disease progression in heart failure

Health experts say that about two to three million Germans suffer from heart failure. Many of them are older people who often lack appetite. Researchers have now found that loss of appetite in patients with heart failure is an additional health risk.

When the heart can no longer adequately supply the body

In Germany, about two to three million people suffer from heart failure (heart failure). As a result of this disease, the heart is no longer able to provide the body with sufficient blood and oxygen. Many of the patients are older people, who also often have comorbidities, including loss of appetite. Scientists at the German Center for Cardiovascular Research (DZHK) have now found out that in heart failure patients who lack appetite, the course of the disease worsens.

Many patients with heart failure are older people who often have little appetite. Researchers have now found that in heart failure patients with poor appetite, the disease worsened. (Image: Robert Kneschke / fotolia.com)

The majority of heart failure patients are the elderly

More than 80 percent of patients with heart failure are older people who for the most part also have comorbidities. These additional health problems affect the performance, quality of life, and survival of heart failure patients.

Typical comorbidities include muscle atrophy and unwanted weight loss from muscle breakdown. Also loss of appetite is often observed in heart failure patients.

However, little was known so far about how the reduced appetite affects the course of the disease in heart failure patients.

Privatdozent Dr. Stephan von Haehling from the University Medical Center Göttingen and his colleagues have therefore examined in the context of the EU-funded SICA-HF study (Studies Investigating Co-morbidities Aggravating Heart Failure) whether anorexia has an effect on the physical performance and the survival rate of heart failure patients.

In addition, they have been looking for factors that may contribute to the loss of appetite. In the journal "ESC Heart Failure" the researchers reported on their results.

Unfavorable interaction

A total of 166 clinically stable, non-inpatient heart failure patients were asked if they had lost their appetite, and one-third said they were suffering from anorexia.

The physical performance of the study participants was determined, among other things, with balance exercises, a 6-minute walk test as well as endurance and strength tests.

It showed that the performance was worse when the appetite of the study participants had decreased. The fitness was even more limited when in addition to loss of appetite (anorexia) an unwanted, severe weight loss (cachexia) was present.

More deaths with less appetite

The Göttingen DZHK scientists also found that the mortality risk is increased over the course of two years, when heart failure patients have less appetite. Cachexia also had an additional negative effect here.

"The interaction of cachexia and loss of appetite is complex and also a problem for other chronic diseases," explains von Haehling.

"For example, 'anorexia cachexia syndrome' is known as a negative disease sequence in cancer patients and its treatment is a major challenge."

Possible triggers

In search of factors that favor loss of appetite for heart failure, the researchers found three independent predictive features: the activation of inflammatory hormones, the use of loop diuretics, and cachexia.

"Heart failure patients already have elevated levels of inflammation, and if those levels are exceeded, the appetite will be more likely to fade," explains von Haehling.

Diuretics diuretics diuretics are prescribed to patients with cardiac insufficiency to reduce tissue retention.

Presumably, they can cause the loss of trace elements such as zinc, the sense of taste and thus also reduce the appetite.

Scientists say: treating physicians must keep an eye on the nutritional habits and nutritional status of their patients in the treatment of heart failure.

"These factors should be a fundamental part of the overall medical assessment of heart failure patients," recommends von Haehling. (Ad)