Lifestyle Changes for Heart Failure

Small changes can make a big difference

Following recommendations about eating patterns, exercise and other habits can help alleviate heart failure symptoms, slow your disease’s progression and improve your everyday life. Making some of these lifestyle changes can be easier said than done. But working these changes into your daily routine can make a real difference in your quality of life. In fact, people with mild to moderate heart failure often can lead nearly normal lives as a result.

Important lifestyle changes will likely include:

Monitoring your weight

Sudden weight gain or loss can be a sign that you’re developing heart failure or that your heart failure is progressing. Even if you’re feeling fine, your health care professional needs to know about weight changes so that your medications can be adjusted if needed. This may help you avoid hospitalization for worsening heart failure. Ask your health care professional or nurse how much fluid to drink every day.

Weigh yourself at the same time each morning, preferably before breakfast and after urinating. Always wear the same types of clothes (try to weigh yourself without shoes) and use the same scale in the same location. This will help you to see actual changes in weight from day to day. Write down your weight and be sure to bring a copy with you each time you visit your health care professional.

Notify your health care professional if you gain two to three pounds in one day for several days in a row, five or more pounds in one week or whatever amount your health care team told you to report.  

Learn more about maintaining a healthy weight.

Quitting smoking

Nicotine from tobacco smoke increases heart rate and blood pressure for a short time. Carbon monoxide also gets in the blood and robs your heart and brain of needed oxygen. Smoking decreases your tolerance for physical activity and increases the tendency for blood to clot. It also decreases HDL (good) cholesterol.

Learn more about quitting smoking.

Being physically active

Regular, moderate-intensity physical activity can help your heart get stronger. Physical activity is anything that makes you move your body and burns calories, such as walking, raking leaves, climbing stairs or playing sports. It becomes regular when you do an activity consistently. How much activity and what kinds of activity you can do depend on the level of your heart health. Your cardiac rehab team can help you design a physical activity plan that’s right for you.

If you’re not physically active, talk to your health care professional about starting an exercise regimen. Schedule physical activity at the same time every day so it becomes a regular part of your lifestyle. If moderate exercise isn’t possible for you, consider participating in a structured rehabilitation program.

Getting enough rest

It’s important to schedule time every day for rest and relaxation. Rest times are essential because they give the heart a chance to pump more easily. Daytime rest can help keep you from overdoing it and ease feelings of tiredness caused by nighttime sleep interruptions.

You might try napping after lunch, putting your feet up for a few minutes every couple of hours or sitting down while performing household tasks such as preparing food or ironing.

To improve your sleep at night, use pillows to prop up your head. Avoid naps and big meals, caffeine, and alcohol right before bedtime. Talk to your health care team to see if you can time your diuretic use so that you’re less likely to wake up to urinate. This may mean taking diuretics in the morning.

Learn about sleep apnea and heart disease.

Managing stress

You may be feeling anxious or nervous about your diagnosis and what might happen to you and your family. And everyone has certain stress triggers — things that cause your heart to pound and make you breathe harder. It’s important to work to manage stress and anxiety. They make the heart work harder, which can make symptoms worse.

Don’t use smoking, drinking, overeating or drugs to cope with stress, as these habits can make your condition worse. Instead, try things like:

• Taking 15 to 20 minutes a day to sit quietly, breathe deeply and think of a peaceful scene.
• Trying a class in yoga or meditation. (Check with your health care professional first before undertaking a strenuous yoga class.)
• Counting to 10 before answering or responding when you feel angry.
• Joining a support network.

Learn more about managing stress.

Additional considerations

Tracking your daily fluid intake

If you have heart failure, it’s common for your body to retain fluid. So your health care team might recommend limiting your liquid intake.

Many people are prescribed diuretics (water pills) to help them get rid of extra water and sodium to reduce their heart’s workload.

Talk with your health care professional about how much liquid to drink every day.

Avoiding or limiting alcohol

If you drink alcohol, do so in moderation. This means no more than one to two drinks per day for men and one drink per day for women. Talk to your health care professional about whether it’s OK for you to drink alcohol.

Learn more about alcohol and heart disease.

Eating for a healthy heart

Eat an overall healthy eating pattern that emphasizes a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes, and non-tropical vegetable oils. Also, limit saturated fat, trans fat, cholesterol, sodium, red meat, sweets and sugar-sweetened beverages.

Monitoring your blood pressure

Monitoring blood pressure at home, in addition to regular monitoring in a health care professional's office, can help control high blood pressure.

Chart your blood pressure readings over time. This can reveal trends and help to eliminate false readings.

Find out more about how healthy eating can lower your blood pressure with the DASH eating plan.

Avoiding flu and pneumonia with vaccinations

Flu (influenza) and pneumonia pose greater dangers for people who have heart failure than for healthy people. Pneumonia is a lung infection that you can develop if you get the flu. It keeps your body from using oxygen as well as it should. Your heart has to work harder to pump oxygenated blood through the body.

Ask your health care team about getting a yearly flu vaccine and a one-time pneumococcal vaccine to guard against the most common form of bacterial pneumonia. Both vaccines are generally safe and seldom cause any severe reactions. It’s much riskier not to have the vaccines.

In addition:

• Avoid anyone who has a cold or the flu as much as possible.
• Stay out of crowds during the height of flu season (usually October through March).
• Wash your hands well and often, especially after using the bathroom and before eating, and ask that your caregivers do the same.
• Keep your hands away from your face.

Read more about flu and pneumonia.

Stay safe from COVID-19

People with cardiovascular risk factors or heart disease, along with heart attack and stroke survivors, generally should get vaccinated against COVID-19 because they are at much greater risk from the virus than they are from the vaccine, American Heart Association experts say. The AHA urges people with medical conditions to discuss vaccination with their health care team. Learn more about COVID-19 vaccination.

Following heart patient guidelines for sexual activity

Many people are concerned about resuming sexual relations after their heart failure diagnosis. Try not to feel embarrassed about talking about it with your physician or other members of your health care team.

If you have heart failure, being able to have sex depends on your symptoms and the severity of your heart failure. People with mild heart failure can usually safely have sex. If you have more severe heart failure symptoms, sex should be avoided until your condition is stable and well managed. Your health care professional will tell you when it’s safe to resume sexual activity. Some people with heart failure may not be able to have intercourse but may be able to engage in other activities.

You should have open and honest talks with your partner about sex. Good communication may lead to resuming sex earlier and enjoying it more.

Learn more about sex and heart disease.