Lifestyle Changes for Heart Failure

Small changes can make a big difference

Following your health care professional’s recommendations about diet, exercise and other habits can help: 

• Lessen heart failure symptoms
• Slow your disease’s progression 
• Improve your everyday life

Making some of these lifestyle changes can be easier said than done. But working these changes into your routine can make a difference in your quality of life. People with mild to moderate heart failure can often lead nearly normal lives with lifestyle changes.

You may need to:

Monitor your weight 

Sudden weight gain or loss can be a sign that you’re developing heart failure or that your heart failure is getting worse. Even if you feel OK, your health care professional needs to know about weight changes. They can adjust your medications if needed. This may help you avoid a hospital stay for worsening heart failure. Ask your health care professional how much fluid to drink daily.

Weigh yourself at the same time each morning, before breakfast and after urinating: 

• Always wear the same type of clothes
• Don’t wear shoes
• 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 bring a copy 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 
• Whatever amount your health care team told you to report  

Learn more about maintaining a healthy weight.

Quit smoking 

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

Learn more about quitting smoking.

Be 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 
• Playing sports 

It becomes regular when you do an activity consistently. How much activity and what kinds you can do depend on your heart health. Your cardiac rehab team can help you design an activity plan that’s right for you.

If you’re not physically active, talk to your health care professional about starting an exercise program. Schedule activity at the same time every day so it becomes a habit. If moderate exercise isn’t possible, consider joining a structured rehabilitation program.

Get enough rest

It’s important to schedule time every day for rest and relaxation. Rest times 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 sleep interruptions at night.

You might: 

• Nap after lunch
• Put your feet up for a few minutes every couple of hours 
• Sit down while doing 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 water pill (diuretic) use so you’re less likely to wake up to urinate. This may mean taking your water pills in the morning.

Learn about sleep apnea and heart disease.

Manage stress 

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

Don’t smoke, drink, overeat or use drugs to cope with stress. These habits can make your condition worse. Instead, try things such as:

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

Learn more about managing stress.

Additional considerations:

Track 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 take 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.

Avoid or limit 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.

Eat for a healthy heart 

Eat an overall healthy eating pattern that emphasizes: 

• A variety of fruits and vegetables
• Whole grains
• Low-fat or fat-free dairy products
• Skinless poultry and fish
• Nuts and legumes
• Nontropical vegetable oils 

Also, limit:

• Saturated fat 
• Trans fat
• Cholesterol 
• Sodium
• Red meat
• Processed meats
• Sweets and sugar-sweetened beverages

Monitor your blood pressure

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

Chart your blood pressure readings over time. This can show trends and help to prevent false readings. 

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

Avoid 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 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 oxygen-rich 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 rarely cause 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. 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. They are at much greater risk from the virus than they are from the vaccine, American Heart Association experts say. The Heart Association urges people with medical conditions to talk about vaccinations with their health care team. 

Learn more about COVID-19 vaccination.

Follow heart patient guidelines for sexual activity 

Many people worry about resuming sexual relations after their heart failure diagnosis. Try not to feel embarrassed talking about it with 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 sex. 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.