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Related Media: Coping with the Challenges of Heart Failure

Lifestyle changes can play an important role in managing heart failure by slowing progression of the disease, helping you feel better, and decreasing impact of the disease on your day-to-day life.

Dietary Changes

If you are not on a special diet to manage other conditions, your doctor may recommend dietary changes. These changes include:

Lose Excess Weight

Excess weight can put a strain on the heart muscle, which can worsen your heart failure symptoms. If you are overweight, talk with a dietitian who can help you with portion control and meal planning. Eating a balanced diet will help you lose weight safely and maintain it once you attain the proper weight.

Monitor Salt and Fluid Intake

If you have problems with fluid accumulation in your lungs, abdomen, legs, ankles, or feet, it is important to be careful of your sodium and fluid intake. You may need to restrict your intake, or cut out excess intake depending on the severity of your symptoms.

Foods that are high in sodium cause your body to retain fluids. Sodium comes not only from table salt but is also added to many of foods you eat including processed foods, such as breads, deli meats, or condiments. It is important to read food labels to see the sodium content so you can better manage your total daily intake.

Ask your doctor or dietitian how much salt and fluid is right for you.

Limit Fats and Cholesterol

Saturated fats and cholesterol cause hardening and blockages in your arteries. These blockages make your heart work harder to pump blood. Limiting the amount of saturated fats and cholesterol in your diet can help decrease these blockages and ease heart strain. Saturated fats are found in animal products, cream, lard, and palm and coconut oils. Talk with a dietitian about easy substitutions you can make that will allow you to eat heart healthy fats.

Quit Smoking

Smoking makes your heart work harder because it increases blood pressure and heart rate while reducing the amount of oxygen in your blood. Talk with your doctor about the best way to help you quit smoking. Also remember that secondhand smoke is also harmful. Make sure you are not exposed to cigarette smoke if at all possible. Not smoking reduces your blood pressure and heart rate within minutes.

Maintain Normal Blood Pressure

High blood pressure is a primary cause of heart failure because the heart has to work harder to push blood out into the body against the high pressure. Work with your doctor to keep your blood pressure under control. This may include medications and lifestyle changes like regular exercise and dietary changes. The DASH diet has been shown to help reduce blood pressure by lowering your daily salt intake. Talk to your doctor or dietitian to see if the plan could work for you.

Decrease or Discontinue Alcohol Consumption

Excessive use of alcohol can further weaken the heart and increase your chance of arrhythmias. Alcohol also may react with certain medications.

Reduction or elimination of alcohol can help improve heart failure-related symptoms. Moderate drinking is considered to be two drinks per day for men and one drink per day for women.

Exercise Regularly

Do not begin any exercise program without consulting your doctor.

Even though you might find that you are unable to exercise as vigorously as in the past, keeping as physically active as possible is an important goal in managing your heart failure. Regular aerobic training can help increase your physical abilities and quality of life. You should aim to exercise for at least 30 minutes per day on most days of the week. Begin slowly and work your way to this goal. Depending on the symptoms and severity of your condition, your doctor may have you do an exercise test before starting a program.

If you have severe heart failure, heavy lifting or extreme exertion is not recommended.

Sexual Activity

It is normal for you or your partner to feel concerned about whether it is safe for you to resume sexual activity. In general, people who have heart failure that is stable and properly treated can engage in sexual activity. To find out what is safe for you, make an appointment to discuss this issue with your doctor.

Take Prescribed Medications

Take any medications your doctor has prescribed, such as diuretics for edema, or beta blockers for high blood pressure. Use medications as recommended by your doctor, or according to the instructions provided. Talk with your doctor if you have questions about usage or side effects.

Counseling

If you are having trouble managing your heart failure, ask your doctor about counseling. Counselors can help you navigate challenges of living with a chronic condition. It also may be beneficial to join a support group so you can interact with others who have heart failure. They offer an environment of encouragement and support that will help you adjust and adhere to your treatment.

Other Management
  • Oxygen therapy—Increases oxygen in the blood. Oxygen therapy may allow you resume or continue activities.
  • Vaccination—Yearly flu and pneumonia shots can help prevent respiratory infections.
  • Cardiac rehabilitation—Provides supervised education and counseling to increase exercise, manage symptoms, and reduce the risk of further heart-related conditions.
  • Follow any additional recommendations from your doctor, such as monitoring your weight on a daily basis. Record and report significant weight gains that occur in a day or week. An upswing in weight may indicate a worsening of your heart failure.
  • Maintain regular communication with your health care team, adhere to your treatment plan, and go to any recommended appointments. Your needs may change over time. Regular contact with your healthcare team will help you stay on top of any changes.
  • Be an active participant in your care. Talk to your team about symptoms or treatments that you are having difficulty with. Other treatments options may be available to help you better manage your heart failure.
When to Contact Your Doctor

If you have heart failure, there are some common warning signs that may signal your condition is worsening. Contact your doctor if you notice any of these symptoms:

  • Sudden weight gain
  • Shortness of breath that wakes you up at night, is present at rest, or is increased with exertion
  • Increased swelling in the limbs, legs, or ankles
  • Swelling in the abdomen, lack of appetite, or nausea
  • Trouble sleeping
  • Frequent dry, hacking cough
  • Increased fatigue

Remember, it is important to maintain contact with your health care team and go to any scheduled appointments.

References:

ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2009;119(14):1977-2016.

Cabo J, Alonso R, et al. Omega-3 fatty acids and blood pressure. Br J Nutr. 2012;107 Suppl 2:S195-S200.

Goldenberg I, Jonas M, et al. Current smoking, smoking cessation, and the risk of sudden cardiac death in patients with coronary artery disease. Arch Intern Med. 2003;163:2301.

Heart failure. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 7, 2013. Accessed October 9, 2013.

Heart failure exercise/activity guidelines: exercise. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/disorders/Heart_Failure/hic_Heart_Failure_Exercise-Activity_Guidelines.aspx. Accessed October 9, 2013.

How is heart failure treated? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/hf/treatment.html. Updated January 9, 2012. Accessed October 9, 2013.

Lifestyle changes for heart failure. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Lifestyle-Changes-for-Heart-Failure_UCM_306341_Article.jsp. Updated September 20, 2012. Accessed October 9, 2013.

Medicare and joint commission national hospital inpatient quality measures. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 5, 2013. Accessed October 9, 2013.

Paterna S, Parrinello G, et al. Medium term effects of different dosage of diuretic, sodium, and fluid administration on neurohormonal and clinical outcome in patients with recently compensated heart failure. Am J Cardiol. 2009;103:93-102.

Physical changes to report. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Physical-Changes-to-Report_UCM_306356_Article.jsp. Updated September 20, 2012. Accessed October 9, 2013.

Physician quality reporting system 2011 quality measures. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 5, 2013. Accessed October 9, 2013.

What is cardiac rehabilitation? American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/CardiacRehab/What-is-Cardiac-Rehabilitation_UCM_307049_Article.jsp. Updated August 14, 2012. Accessed October 9, 2013.

The Trials of Hypertension Prevention Collaborative Research Group. The effects of nonpharmacologic interventions on blood pressure of persons with high-normal levels. Results of the Trials of Hypertension Prevention, Phase 1. JAMA. 1992;267:1213.

4/16/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Nilsson BB, Westheim A, et al. Effects of group-based high-intensity aerobic interval training in patients with chronic heart failure. Am J Cardiol. 2008 Nov 15;102:1361-1365.

4/5/2012 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Levine GN, Steinke EE, et al. Sexual activity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2012;125(8):1058-1072.

3/5/2013 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Dinicolantonio JJ, Pasquale PD, Taylor RS, et al. Low sodium versus normal sodium diets in systolic heart failure: systematic review and meta-analysis. Heart. 2013 Jan 24. [Epub ahead of print.]



Last reviewed September 2013 by Michael J. Fucci, DO

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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