Preoccupation with dietary management of heart failure—originally in relation to the control of edema and obesity and more recently in regard to hypertension, coronary atherosclerosis, and myocardial infarction—has obscured many other facets of the interdependence of heart disease, heart failure, and nutritional status. It seems worthwhile, in the hope of stimulating more direct studies, to review both the obvious and the subtler—perhaps even far-fetched—relationships between heart disease or failure and malnutrition. It is apparent that a two-way reaction is involved: On the one hand, in many ways heart failure leads to nutritional deficiency, while on the other hand, certain types of malnutrition produce myocardial insufficiency—often by unknown means.
Influence of Heart Failure on the State of Nutrition
Heart failure can influence the state of nutrition in a variety of ways. First, there is the reduction in food intake in general—at times, of protein food in particular—as a result of visceral