Treating Heart Failure: The Smartest Approach

Other conditions related to heart failure. A significant number of patients with heart-failure symptoms have no apparent heart abnormality on their imaging scans. These folks often have a stiffening of the heart muscle caused by some underlying condition like uncontrolled high blood pressure, diabetes, chronic kidney disease, or a cardiac arrhythmia like atrial fibrillation. "In this case, the guidelines say to focus primarily on treating these conditions," Yancy says, like getting diabetes or hypertension under control through medication and lifestyle changes.

Dangers of too much sodium. It's always smart to follow a diet plan focusing on whole grains, low-fat protein, and fruits and vegetables. (Consider the heart-healthy DASH plan.) Heart-failure patients also must make every effort to cut down on salt to prevent excess fluid buildup in the lungs, ankles, and abdomen that can make breathing and walking harder. The AHA recommends limiting sodium to no more than 2,000 milligrams a day, which means avoiding such foods as table salt, sports drinks, ketchup, cured meats, and instant and prepared foods, as well as high-sodium medications like Alka-Seltzer. In other words, read all labels for sodium content. This really does take effort: An April study from Emory University found that only one third of heart-failure patients could reduce their sodium intake to 2,000 mg a day even when they tried to follow a low-sodium diet. A good way to tell if you're getting too much salt: Weigh yourself every day, says Fonarow. If you gain more than 2 or 3 pounds from one day to the next, it's probably an indication that your body is retaining too much water. You'll need to cut back on sodium, or, if that doesn't work, he says, you may need a higher dose of diuretics.

A safe level of exercise. Heart-failure patients have to be particularly careful about overexerting themselves. For instance, they should avoid resistance training with heavy weights, says Fonarow. But with a doctor's OK, many can engage in mild cardiovascular activities like walking, swimming, or biking. And some recent studies suggest that regular exercise could reduce heart-failure symptoms like fatigue and shortness of breath, though it's not clear whether exercise actually lowers either death or hospitalization rates.