The Truth About Dealing With Heart Failure
A guide to reducing risks and living well even if you develop the condition
Congestive heart failure is a serious illness. But it does not, as is sometimes thought, mean the heart stops altogether. It signifies that the muscle is damaged and can no longer pump enough blood to meet the body’s needs.
This condition, which affects 1 in 5 adults—usually in the later years—can shorten life. But with proper treatment, people are living longer and better with heart failure.
“We have more medications at our disposal today to improve quality of life for people with a weakened heart,” says Guy L. Mintz, M.D., director of cardiovascular health and lipidology at Sandra Atlas Bass Heart Hospital in Manhasset, N.Y.
Here’s what to do.
Coronary artery disease and heart attacks are major causes of heart failure, says cardiologist Tamara Horwich, M.D., medical director of UCLA’s cardiac rehabilitation program in Los Angeles. Managing your risk for problems—such as high blood pressure, high cholesterol, and type 2 diabetes—that could lead to such conditions is the best way to protect the heart muscle from injury.
Physical activity five or more days a week and a healthy, plant-based diet are key. “Focus on eating lots of vegetables and fruits [five or more daily servings] and limiting processed foods,” Horwich says. If you have high blood pressure, high cholesterol, or diabetes, taking medication as prescribed could also cut heart failure risks, she adds.
“Heart failure is a constellation of signs and symptoms that the heart is no longer pumping as it should be,” Mintz says.
Common symptoms include shortness of breath during activity, such as going up and down stairs; swelling in the lower limbs or abdomen; and trouble breathing while lying flat. You may feel the need to prop yourself up with pillows to sleep.
If you experience such symptoms, see your primary care doctor, Horwich says. He or she may recommend tests such as a chest X-ray to look for fluid in the lungs and an electrocardiogram (EKG) to evaluate your heart’s electrical activity. A cardiologist may confirm a weakened heart muscle via echocardiogram (ECG), which shows how well your heart pumps blood.
Heart failure can’t usually be cured, but you may be able to alleviate symptoms by following your medication regimen and making lifestyle changes. So:
Quit smoking. Doing so can lower blood pressure and heart rate almost immediately, which can ease shortness of breath.
Eat right. Stick to a diet rich in fresh fruits and veggies, whole grains, low-fat dairy, lean meat, fish, nuts, and legumes. Reduce your intake of processed food.
Watch your sodium. Though most experts advise a low-sodium diet for heart failure, it has been neither proved nor disproved to cut symptoms. However, salt helps the body retain fluid. “If you have a lot of congestive symptoms, such as swelling in your legs and feet, limiting your sodium intake to around 2,000 mg per day may help,” Horwich says.
Get physical activity. It helps to reduce your heart’s workload. Ask your doctor whether you might benefit from a formal exercise-based cardiac rehab program, which might be covered by insurance.
To keep symptoms at bay, it’s essential to take your medications as recommended, and on time. For systolic heart failure (the heart pumps with too little force), meds might include angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), which open blood vessels and reduce blood pressure, or a newer combination drug, sacubitril/valsartan (Entresto).
Meds for people with diastolic heart failure, where the heart can’t relax enough to fill with blood between pumps, may include beta-blockers, to slow heart rate and decrease the strength of heart contractions.
In both cases, your doctor may also prescribe diuretics to reduce extremity swelling and fluid in the lungs.
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