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Lifestyle Changes to Manage Congestive Heart Failure (CHF)

Lifestyle Changes to Manage Congestive Heart Failure (CHF)

Main Page | Risk Factors | Symptoms | Diagnosis | Treatment | Screening | Reducing Your Risk | Talking to Your Doctor | Resource Guide

Congestive heart failure (CHF) is often managed by a combination of prescribed medical treatment and certain lifestyle changes.

General guidelines

Managing Congestive Heart Failure

Lose Excess Weight

Excess weight can put a strain on the heart muscle, which can eventually lead to CHF. If you are overweight, adopt a sensible eating plan that will enable you to lose weight gradually and maintain your weight at the desired level. One indicator of healthy weight is body mass index. BMI of 25 and above is associated with high blood cholesterol, high blood pressure, and increased risk of heart disease.

Discontinue or Avoid Smoking

Smoking damages your blood vessels, reduces the amount of oxygen in your blood, and forces your heart to work harder. Discuss with your doctor the best way to help you quit smoking . Also remember that secondhand smoke is detrimental to your health. Make sure you are not exposed to cigarette smoke at all. When you quit smoking your risk of heart disease drops significantly within the first year.

Eat a Low Sodium Diet

Foods that are high in sodium (salt) cause your body to retain fluids. This results in an increased workload for your heart, and it can worsen your shortness of breath and swelling in the ankles, legs, and feet. Ask your doctor how much salt and fluid is right for you.

Limit Fats and Cholesterol

Diets that are high in saturated fats and cholesterol—such as animal products, cream, lard, palm and coconut oils—can increase your risk of coronary artery disease , which can lead to CHF. You may want to consult with a dietitian to learn which foods you should restrict or avoid to help reduce saturated fats, trans fats, and cholesterol.

Maintain Normal Blood Pressure

High blood pressure (hypertension) is a critical risk factor for CHF. Patients with poorly controlled blood pressure run twice the risk of developing heart failure compared with those people who do not have high blood pressure. Hypertension causes the heart muscle to work harder than normal. The increased strain on the heart, and the changes in the muscle in response to the strain, may eventually result in a weakened heart muscle and heart failure. Discuss with your doctor the best way to reach and maintain a healthy blood pressure.

Decrease or Discontinue Alcohol Consumption

Excessive use of alcohol can weaken the heart and predispose it to abnormal rhythms. Alcohol also may react with certain heart medications. You should reduce alcohol intake if you are at risk of developing CHF; you will definitely need to discontinue alcohol consumption if you develop CHF. Talk with your doctor about how best to accomplish this.

Exercise Regularly

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 CHF. Research suggests that people with stable CHF who participate in high-intensity aerobic training experience improvements in their physical activity level and quality of life. Do not begin any exercise program without consulting your doctor. 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 CHF, heavy lifting or extreme exertion is not recommended.

When to Contact Your Doctor

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

  • Sudden weight gain (three or more pounds in one day, five or more pounds in one week, or whatever amount you were told to report)
  • 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 (waking up short of breath, using more pillows)
  • Frequent dry, hacking cough
  • Increased fatigue

References:

American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1200000 .

Goldenberg I, Jonas M, Tenenbaum A, 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.

Harrison’s Principles of Internal Medicine . 15th ed. McGraw-Hill; 2001.

Knapp HR, FitzGerald GA. The antihypertensive effects of fish oil: a controlled study of polyunsaturated fatty acid supplements in essential hypertension. N Engl J Med. 1989;320:1037.

Mayo Clinic Heart Center website. Available at: http://www.mayoclinic.com/health/heart-failure/HB00061 . Accessed January 30, 2007.

Paterna S, Parrinello G, Cannizzaro S, 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. Epub 2008 Oct 17.

Siscovick DS, Raghunathan TE, King I, et al. Dietary intake and cell membrane levels of long-chain n-3 polyunsaturated fatty acids and the risk of primary cardiac arrest. JAMA. 1995;274:1363.

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.

¹4/16/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Nilsson BB, Westheim A, Risberg MA. Effects of group-based high-intensity aerobic interval training in patients with chronic heart failure. Am J Cardiol. 2008 Nov 15;102:1361-1365. Epub 2008 Sep 11.



Last reviewed September 2009 by David N. Smith, MD

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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