Medical Management for Heart Failure
The Center for Heart Failure offers the latest in medical management for patients with all stages of heart failure. Our world-renowned team of expert physicians evaluate the severity of heart failure and recommend a course of therapy (based on state-of-the-art guidelines for medical management of heart failure) in order to reduce symptoms, improve function, enhance quality of life and improve survival.
Medical treatment for heart failure has evolved dramatically over the last 15 years. Many people who previously could not be helped are now experiencing increased survival and significant improvement in their symptoms of heart failure. Medications used to treat heart failure include:
- ACE inhibitors
- angiotensin receptor blockers
The medications used for a patient depends on a number of variables, such as the degree of heart dysfunction, the presence of kidney dysfunction and other diseases that the patient may have. Diet, exercise and lifestyle changes are also an important part of the medical treatment for heart failure.
Angiotensin Converting Enzyme Inhibitors (ACE Inhibitors)
Dilates (opens up) the blood vessels to allow the heart to pump the blood more effectively and blocks neurohormones that can damage the heart.
Examples: lisinopril, enalapril, ramipril, captopril, benazepril, fosinopril, quinapril, trandolapril
Angiotensin Receptor Blockers (ARBs)
Dilates (opens up) the blood vessels to allow the heart to pump the blood. Sometimes used as an alternative to ACE Inhibitors or in conjunction with ACE Inhibitors in some cases.
Examples: losartan, valsartan, candesartan, irbesartan, telmisartan, eprosartan, olmesartan
Blocks the effect of the neurohormones which can damage the heart, also slows heart rate and lowers blood pressure.
Examples: carvedilol, metoprolol succinate
"Water pills" which help rid the body of excess fluid and sodium that causes the body to retain fluid.
Examples: furosemide, torsemide, metolazone, bumetanide, hydrochlorothiazide
Helps strengthen the force of the heart contraction.
Blocks hormones produced by the body which can increase HF symptoms.
It is important to take your medicine each day as directed. Do not skip doses or stop taking any medicine without talking with your doctor or nurse. To help you keep track of the medicine you are taking, keep a medication list or chart. Your list should include space to record the name of the medication, dose, and how often each medication is taken. Be sure to bring this list to all doctors' visits. This is important if medications are changed or added. You should also not take any other medications without talking to your heart failure doctor or nurse first because other medications may affect how heart failure medications work or make side effects of your heart failure medications worse.
Low salt diet
A diet high in salt (sodium) makes the body retain extra fluid, which causes the heart to work harder and raises blood pressure. For heart failure patients, a low salt diet (less than 2 grams of sodium a day) can relieve this added stress to the heart.
Quick tips for reducing your salt intake:
- When cooking, add spices and herbs for extra flavor.
- Do not add salt to foods at the table.
- Talk with your doctor or nurse about using a salt substitute.
- Select fresh foods rather than prepared items which are often higher in sodium.
- When shopping, read food labels. Avoid foods that have any of these listed as one of the first three ingredients: salt, brine, MSG, baking powder or any item with the word sodium (monosodium glutamate).
- Be aware that most lunch meats, cheese, ham, hot dogs, canned soups, canned vegetables, canned meats, pickles, chips, pretzels and "fast foods" are high in sodium.
Your nurse, doctor or dietitian may provide more detailed diet guidelines, including limiting your fluid intake. Certain foods "count" as fluids, such as jello, ice cream, yogurt, pudding and juice in oranges and grapefruits. If you are asked to limit fluids, talk with your doctor, nurse, or dietitian about using small amounts of sugar-free candy or gum and other ways to help if you have a dry mouth. As always, follow your health care providers' specific instructions.
Monitor weight every morning
Rapid weight gain is a heart failure warning sign. Weigh yourself daily, early in the morning (before eating or drinking) at the same time every day, using the same scale and wearing the same amount of clothes.
Regular exercise is important to your health. Talk with your doctor about starting an exercise program or joining a formal cardiac rehabilitation program. After a hospital stay, slowly increase your activities each day. During the day, try to walk around every two to three hours. Increase the distance walked each day. To conserve energy, consider doing tasks, such as folding laundry, while seated. When sitting, elevate your feet on a stool. Vary your activities with planned rest periods.
Lose weight if you are overweight. Talk to your doctor about a weight loss program including diet, exercise and counseling.
Tobacco and Alcohol
Stop smoking and drink alcohol sparingly, if at all. Talk with your doctor.
Talk to your doctor or nurse about influenza and pneumococcal vaccinations.
Heart failure is usually treated with medications, diet and lifestyle changes. However, in some cases, certain procedures or surgery may be recommended. Other treatments include:
- Cardiac Resynchronization Therapy (CRT), also called Biventricular Pacemaker Therapy
- Left Ventricular Reconstruction
- Ventricular Assist Devices
- Heart Transplantation
For more information regarding medical management of heart failure, please contact the Bluhm Cardiovascular Institute at 1-866-662-8467 or request a first time appointment online.