Manage Heart Failure for a Higher-Quality, Longer Life
About 5.1 million Americans have heart failure, according to the Centers for Disease Control and Prevention, and of that number, 2.5 million are women. These numbers reflect the fact that the average age of Americans is increasing—most people with the condition are older adults—but they also reflect advances in medicine that mean more and more people are surviving heart attacks. Those individuals live on with damaged hearts: About 28 percent of men and 41 percent of women who survive a heart attack develop heart failure within five years. But heart attack isn’t the only underlying cause of heart failure—it can also result from hypertension, diabetes, a malfunctioning heart valve, and/or cardiomyopathy (a disease that directly affects the heart muscle), among others.
Heart failure is a serious condition that can result in frequent hospitalizations and declining quality of life, and it can lead to early death, especially if it’s left untreated.
“If you have heart failure, eating right, exercising regularly, and being compliant with your medications and your doctor appointments are key to feeling good and reducing exacerbations of the condition,” says Joy Gelbman, MD, a cardiologist at Weill Cornell Medicine.
Reduced Pumping Ability
Heart failure is not a disease itself, but a condition resulting from injury to the heart muscle. While the phrase “heart failure” suggests that the heart is about to stop working altogether, in reality, the term means that the heart is no longer able to effectively pump enough blood to meet your body’s needs. This results in less oxygenated blood reaching the brain, organs and muscles, fluid build-up in the liver, and an increased risk of blood clots forming in the heart.
The most common symptom of heart failure is shortness of breath, which can develop gradually until you reach a point where walking or any form of exertion becomes extremely difficult. Other symptoms include swelling in the legs and feet, fatigue that significantly reduces exercise tolerance, difficulty breathing while lying flat, and lightheadedness. However, these symptoms are not unique to heart failure, so a medical evaluation is necessary to determine what is causing them.
WHAT YOU CAN DO
To slow heart failure progression and
maintain your quality of life:
▶ Exercise regularly
▶ Follow a heart-healthy diet
▶ Get adequate, restful sleep
▶ Lose weight if you’re overweight
▶ Avoid alcohol
▶ Limit fluid intake
▶ Stop smoking if you smoke
▶ Get flu and pneumonia shots yearly—these illnesses can worsen heart failure and increase the risk of death
▶ Keep all appointments with your doctor, and follow your doctor’s instructions carefully
An evaluation for heart failure will require a careful physical examination. Blood and urine tests and other noninvasive tests, such as a stress test, echocardiogram, magnetic resonance imaging (MRI) test, or coronary computed tomography (CT) angiogram, also may be ordered.
Treating Heart Failure
Heart failure develops most commonly in people who’ve had a prior heart attack and suffered damage to part of the heart. It follows that treating the cardiovascular risk factors that can underpin heart attack (for example, high blood pressure, high blood sugar, and high cholesterol) can help you manage heart failure.
Eating a diet high in fruits and vegetables, whole grains, and healthy fats, and low in saturated and trans fats, can slow your heart’s deterioration and improve your quality of life if you have heart failure. Getting enough exercise is also important, even though it might seem counterintuitive, given that your shortness of breath will likely make physical activity challenging. However, exercise can help you lose weight—an important treatment target since the majority of heart failure patients are overweight. If you need help devising a diet and exercise program, ask your cardiologist for a referral to a cardiac exercise program.
Medications that can relieve your symptoms and help your heart pump more effectively include beta blockers (Lopressor, Inderal) and ACE inhibitors (Lotensin, Vasotec). If you take over-the-counter or prescription medications for any other health conditions, it is important to tell your doctor, because many common drugs are toxic to heart cells, and they may slow your heart rate, worsen high blood pressure, or interact with heart failure medications. Also tell your doctor about any nutritional or herbal supplements you take.
Advanced heart failure therapies include intravenous medications, heart pumps, and heart transplant.
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