From the Guidelines
Lifestyle modifications are crucial for managing heart failure, and patients should prioritize a low-sodium diet, regular physical activity, weight management, fluid restriction, and stress reduction to improve quality of life and reduce morbidity and mortality. The most recent and highest quality study 1 emphasizes the importance of exercise training and physical activity as a lifestyle intervention in heart failure, highlighting its role in preventing HF and improving cardiovascular health. Key lifestyle modifications for heart failure patients include:
- Adopting a low-sodium diet to reduce fluid retention and decrease cardiac workload
- Engaging in regular physical activity, such as 30 minutes of moderate aerobic exercise, 5 days a week, to strengthen the heart muscle and improve circulation 1
- Achieving and maintaining a healthy weight, with a BMI between 18.5-24.9 kg/m²
- Restricting fluid intake to 1.5-2 liters daily to prevent volume overload
- Limiting alcohol consumption to no more than one drink daily for women and two for men, or avoiding it completely in alcoholic cardiomyopathy
- Quitting smoking to prevent further damage to blood vessels and heart function 1
- Practicing stress reduction techniques, such as meditation, deep breathing, or yoga, to lower blood pressure and heart rate
- Monitoring blood pressure, heart rate, and daily weight to detect early signs of worsening heart failure
- Optimizing sleep with 7-8 hours nightly and treating sleep apnea if present to reduce cardiac strain. These lifestyle changes complement medical therapy by reducing the heart's workload, decreasing inflammation, improving vascular function, and enhancing medication effectiveness 1.
From the Research
Lifestyle Modifications for Heart Failure
Lifestyle modifications play a crucial role in the management of heart failure (HF) [(2,3,4,5,6)]. The following are some of the key lifestyle modifications that can help in the prevention and treatment of HF:
- Diet: A healthy diet is essential for managing HF. The DASH Diet has been shown to be beneficial 2, while the Mediterranean diet does not have enough evidence to support its use 2.
- Exercise: Regular exercise, such as walking, can help improve symptoms and quality of life in patients with HF [(3,5)]. Cardiac rehabilitation is also beneficial 2.
- Smoking cessation: Smoking should be stopped to reduce the risk of HF [(2,5)].
- Alcohol consumption: Excessive alcohol consumption should be avoided, and patients should be advised to drink no more than 30 mL/d of alcohol or abstain completely 5.
- Salt restriction: A moderate salt restriction is better than a strict reduction 2. Patients with mild to moderate HF should be restricted to 3 g/d of sodium initially, and those who are unresponsive to this dosage or who have more severe disease should be advised to consume 2 g/d or less 5.
- Weight management: Weight management is important for patients with HF, especially those who are obese [(3,4)]. However, the evidence for weight loss in obese patients with HF is contradictory 2.
- Self-care: Self-care is essential in the long-term management of chronic HF 6. Patients should be educated on treatment adherence, lifestyle changes, symptom monitoring, and adequate response to possible deterioration.
- Psychological status: Patients with HF should be monitored for psychological status, and interventions such as mindfulness may be beneficial 4.
- Sleep and leisure: Patients with HF should be advised on healthy sleep habits and leisure activities 6.
- Immunization and infection prevention: Patients with HF should be immunized against influenza and pneumococcal disease, and should take measures to prevent infections 6.
- Symptom monitoring and management: Patients with HF should be educated on symptom monitoring and management, and should know how to respond to possible deterioration 6.