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Treating heart failure

  • You and your health care team will create a treatment plan together. Treating heart failure is done to:

    • keep the amount of fluid in your body at a level that your heart can handle
    • start or increase medicines that help your heart pump better

    The goal of treatment is to make you feel better and live longer. Your treatment plan may include:

    • taking medicines
    • eating healthful foods
    • getting regular exercise
    • reducing your stress

    By following your treatment plan, it is possible that you can have a good quality of life for many years!

    Maintain a healthy weight

    Each person has a different amount of fluid his or her heart can handle. In general, most patients have too much fluid and need to lose that fluid weight.

    Your health care provider will recommend a healthy weight for you. If you do not lose the fluid:

    • you will not feel better
    • your medicines won't work as well

    Find your 'dry weight'

    Your "dry" weight is your goal weight. This is how much you weigh when you do not have extra fluid (water) build-up in your body.

    Weigh yourself every morning

    To maintain the right amount of fluid in your body, you need to weigh yourself each morning.

    • Weigh yourself without clothes.
    • Weigh yourself after you go to the bathroom and before you eat or drink anything.
    • Use the same scale.
    • Write down your weight and symptoms in the Heart Failure Weight Log calendar.

    You have fluid weight if you gain:

    • three pounds in one day

      or

    • five pounds or more in one week.

    To lose the extra fluid weight, follow your health care provider's directions.

    Watch how much you drink

    Do not drink more than two liters of liquids each day. This includes water, milk, tea, coffee, soda, ice cream and soup.

    Most patients' hearts cannot handle more than two liters of fluids a day.

    Remember: you need more fluid coming out each day than what goes in. To maintain your weight, the amount of liquids going in each day has to equal what is coming out.

    Limit how much salt you eat

    Limit your sodium (salt) to 1,500 to 2,000 milligrams (mg) each day.

    • Sodium causes your body to retain (keep) water.
    • If you eat more than 2,000 mg a day, your water pills won't work right or maybe not at all.

    Remember: low salt does not mean no salt. Your heart needs salt to work right. Without any salt, you also will not feel well.

    Take your medicines as directed

    There are five types of medicines that work to either improve heart failure or your quality of life. The goal is for you to be on more than two of them at the highest possible doses. The higher dose you can take, the more likely your heart failure will get better.

    • angiotensin receptor blockers (ARBs): They relax your blood vessels so your heart pumps easier. You would be prescribed this if you cannot take an ACE inhibitor. Examples are losartan (Cozaar®), valsartan (Diovan®) and candesartan (Atacand®).
    • beta blockers: They can improve how your heart works. Examples are carvedilol (Coreg®), metoprolol (Lopressor®, Toprol XL®), bisoprolol (Zebeta®)
    • angiotensin converting enzyme (ACE) inhibitors: They allow your heart to pump easier. Examples enalapril (Vasotec®), captopril (Capoten®), lisinopril (Zestril® and Prinivil®), quinipril (Accupril®) ramipril (Altace®). If you can't take ACE inhibitors, you will take an ARB.
    • hydralazine and nitrates: Together, they relax your blood vessels and decrease how hard your heart has to work to pump blood. Examples are hydralazine (Apresoline®), isosorbide dinitrate (Isordil®), isosorbide mononitrate (IMDUR®) or hydralazine/isosorbide dinitrate combination tablet (Bidil®).
      You may take these if you are already taking the highest doses of beta blockers and ACE inhibitors, or if you can't take ACE inhibitors or ARBs.
    • aldosterone antagonists: They block the effects of the stress hormone aldosterone. When your body makes too much aldosterone, it causes your kidneys keep more sodium and water. Examples are spironolactone (Aldactone®), eplerenone (Inspra®).

    Get regular exercise

    Exercise is good for heart failure. The more you exercise, the better your muscles get at pulling the oxygen out of your blood. This means your heart won't have to work as hard.

    Push yourself and do a little more walking each day. Your goal is to walk at least 30 minutes each day.

    Cardiac rehab can improve your quality of life. Talk with your health care provider for more information.

    What else you can do

    There are a few other things you can do to help make your heart healthier:

    • Do not smoke. Learn more about tobacco and how to quit.
    • Do not drink alcohol.
    • Keep all of your clinic and lab appointments.
    • Call your health care provider if your weight goes up or if you have any new symptoms.