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Conditions that damage or overwork the heart muscle can cause heart failure. Over time, the heart weakens. It isn’t able to fill with and/or pump blood as well as it should.

As the heart weakens, certain proteins and other substances may be released into the blood. These substances have a toxic effect on the heart and blood flow, and they worsen heart failure.
Common Causes of Heart Failure

The most common causes of heart failure are coronary heart disease (CHD), high blood pressure, and diabetes. Treating these problems can prevent or improve heart failure.

Diabetes:Diabetes is a disease in which the body’s blood glucose, or blood sugar, level is too high. Normally, the body breaks down food into glucose and then carries it to cells throughout the body. The cells use a hormone called insulin to turn the glucose into energy.

In diabetes, the body doesn’t make enough insulin or doesn’t use its insulin properly. Over time, high blood sugar levels can damage and weaken the heart muscle and the blood vessels around the heart, leading to heart failure.

High Blood Pressure:Blood pressure is the force of blood pushing against the walls of the arteries. If this pressure rises and stays high over time, it can weaken your heart and lead to plaque buildup.

Blood pressure is considered high if it stays at or above 140/90 mmHg over time. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher.

Coronary Heart Disease:CHD is a condition in which a substance called plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle.

Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Plaque narrows the arteries and reduces blood flow to your heart muscle. It also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow.CHD can lead to chest pain or discomfort called angina, a heart attack, heart damage, or even death.

Heart failure often develops after other conditions have damaged or weakened your heart. Over time, the heart can no longer keep up with the normal demands placed on it to pump blood to the rest of your body. The main pumping chambers of your heart (the ventricles) may become stiff and not fill properly between beats. Also, your heart muscle may weaken, and the ventricles stretch (dilate) to the point that the heart can’t pump blood efficiently throughout your body. The term “congestive heart failure” comes from blood backing up into — or congesting — the liver, abdomen, lower extremities and lungs.

Heart failure can involve the left side, right side or both sides of your heart. Typically, heart failure begins with the left side — specifically the left ventricle, your heart’s main pumping chamber.

As stated, the heart loses some of its blood-pumping ability as a natural consequence of aging. However, a number of other factors can lead to a potentially life-threatening loss of pumping activity.

As a symptom of underlying heart disease, heart failure is closely associated with the major risk factors for coronary heart disease: smoking, high cholesterol levels, hypertension (persistent high blood pressure), diabetes and abnormal blood sugar levels, and obesity. A person can change or eliminate those risk factors and thus lower their risk of developing or aggravating their heart disease and heart failure.

Among prominent risk factors, hypertension (high blood pressure) and diabetes are particularly important. Uncontrolled high blood pressure increases the risk of heart failure by 200 percent, compared with those who do not have hypertension. Moreover, the degree of risk appears directly related to the severity of the high blood pressure.

Persons with diabetes have about a two- to eightfold greater risk of heart failure than those without diabetes. Women with diabetes have a greater risk of heart failure than men with diabetes. Part of the risk comes from diabetes’ association with other heart failure risk factors, such as high blood pressure, obesity, and high cholesterol levels. However, the disease process in diabetes also damages the heart muscle.

The presence of coronary disease is among the greatest risks for heart failure. Muscle damage and scarring caused by a heart attack greatly increase the risk of heart failure. Cardiac arrhythmias, or irregular heartbeats, also raise heart failure risk. Any disorder that causes abnormal swelling or thickening of the heart sets the stage for heart failure.

In some people, heart failure arises from problems with heart valves, the flap-like structures that help regulate blood flow through the heart. Infections in the heart are another source of increased risk for heart failure.

A single risk factor may be sufficient to cause heart failure, but a combination of factors dramatically increases the risk. Advanced age adds to the potential impact of any heart failure risk.

Finally, genetic abnormalities contribute to the risk for certain types of heart disease, which in turn may lead to heart failure. However, in most instances, a specific genetic link to heart failure has not been identified.