Facebook Twitter Instagram You Tube Pinterest LinkedIn RSS Podcasts Video Library Blog
 - Northwestern Memorial Hospital - Chicago

Medical Management for Heart Failure

Over the last 25 years, medical treatment for heart failure has evolved dramatically. Many people who previously could not be helped are now experiencing increased survival and significant improvement of their heart failure symptoms. For some patients, medications can improve heart function—making their heart stronger and smaller—while slowing the progression of heart disease.

Northwestern Memorial's Center for Heart Failure at the Bluhm Cardiovascular Institute 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.

The Center for Heart Failure is led by Allen S. Anderson, MD, and Edwin C. McGee, MD. Dr. Anderson is a cardiologist, the medical director of the Center for Heart Failure and the medical director of Heart Transplantation and Mechanical Assistance. He is responsible for medical management of patients. Dr. McGee is a cardiothoracic surgeon, surgical director of the Center for Heart Failure and the surgical director of Heart Transplantation and Mechanical Assistance. Dr. McGee has extensive experience in ventricular assist devices and heart transplantation and is also respoonsible for post-operative management.

Medications for Heart Failure Treatment

Medications used to treat heart failure include:
  • ACE inhibitors
  • angiotensin receptor blockers
  • beta-blockers
  • diuretics
  • digoxin
  • spironolactone/eplernone
Many variables determine which medications are appropriate, including the degree of heart disease, the presence of kidney dysfunction, and other diseases the patient may have.

Angiotensin Converting Enzyme Inhibitors (ACE Inhibitors)

These medications dilate (open up) blood vessels to allow the heart to pump blood more effectively. They also block neurohormones that can damage the heart.
Examples: lisinopril, enalapril, ramipril, captopril, benazepril, fosinopril, quinapril, trandolapril

Angiotensin Receptor Blockers (ARBs)

These medications dilate (open up) blood vessels to allow the heart to pump blood. Sometimes they are used as an alternative to—or in conjunction with—ACE Inhibitors.
Examples: losartan, valsartan, candesartan, irbesartan, telmisartan, eprosartan, olmesartan

Beta Blockers

These medications block the effect of neurohormones, which can damage the heart. They also slow the heart rate and lower blood pressure.
Examples: carvedilol, metoprolol succinate, bisoprolol

Diuretics

Commonly known as "water pills," these medications help rid the body of excess fluid and sodium that causes the body to retain fluid. There are three types of diuretics: thiazide, loop and potassium-sparing.
 
Thiazide diuretics include:
  • Chlorothiazide
  • Hydrochlorothiazide (Microzide)
  • Indapamide
  • Metolazone (Zaroxolyn) 
Loop diuretics include:
  • Bumetanide
  • Ethacrynic acid (Edecrin)
  • Furosemide (Lasix)
  • Torsemide (Demadex) 
Potassium-sparing diuretics include:
  • Amiloride
  • Eplerenone (Inspra)
  • Spironolactone (Aldactone)
  • Triamterene (Dyrenium) 

Digoxin

This medication helps strengthen the force of the heart contraction.

Spironolactone/Eplerenone

This medication blocks a hormone (aldosterone) produced by the body, which can increase heart failure symptoms.

The Importance of Taking Medication Correctly

Taking your medication(s) daily as prescribed by your health care provider is essential for maximum effectiveness. Do not skip doses or stop taking any medicine without talking with your doctor or nurse.
 
Use a chart or list to keep track of all medications you are taking. Include space to record the name and dose of each medication, and how often each medication is taken. Bring this list to all of your medical appointments; you’ll save yourself (and the staff) time by having your list at hand, and avoid making any mistakes. Keeping track of your medications also makes it easier to track any changes or additions to the list.
 
You should never start taking any other medications without first talking to your heart failure doctor or nurse. Other medications may affect how heart failure medications work, or cause the side effects of your heart failure medications to worsen.

The Value of Diet in Treating Heart Failure

There are two key dietary changes that can have meaningful impact for heart failure patients: reducing salt and restricting fluid intake.

Low-Salt Diet

A diet high in salt (sodium) makes the body retain extra fluid, causing the heart to work harder and raising blood pressure. For heart failure patients, a low-salt diet (less than two grams of sodium a day) can relieve this added stress to the heart.
 
Here are some 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 (or monosodium glutamate).
  • Avoid lunch meats, cheese, ham, hot dogs, canned soups, canned vegetables, canned meats, pickles, chips, pretzels and "fast foods," which usually are high in sodium.

Fluid Restriction

Your nurse, doctor or dietitian may provide more detailed diet guidelines that include limiting your fluid intake. Certain foods count as fluids, including:
  • Flavored gelatin
  • Ice cream
  • Yogurt
  • Pudding
  • Fruit juices
If you are asked to limit fluids, talk with your doctor, nurse or dietitian about using small amounts of sugar-free candy or gum to help relieve symptoms of dry mouth.

Treating Heart Failure with Lifestyle Changes

In addition to medications and dietary modifications, lifestyle changes can also help treat your heart failure symptoms.

Monitor Your 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 clothing.

Exercise Regularly

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 take at least a short walk every two to three hours; each day, increase the distance you walk. 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.

Manage Obesity

If you are overweight, talk with your doctor about a weight loss program including diet, exercise and counseling. Northwestern Memorial offers nutritional counseling through the Center for Preventive Cardiology.

Minimize or Eliminate Tobacco and Alcohol

Stop smoking and drink alcohol sparingly, if at all. We offer smoking cessation assistance through our Cardiac Behavioral Medicine service.

Stay Up-to-Date On Vaccinations

Talk to your doctor or nurse about influenza and pneumococcal vaccinations.

Additional Methods for Treating Heart Failure

In some cases, medication, dietary modifications and lifestyle changes may not be enough to manage your heart failure symptoms. Additional procedures or surgery may be recommended. Other treatments include:

Contact Us Today

For more information regarding medical management for heart failure or to obtain a consultation, please contact the Bluhm Cardiovascular Institute at 1-866-662-8467 or request a first time appointment online.

Clinical Trials

For more information regarding clinical trials related to heart failure, please visit the Clinical Trials Unit of Northwestern, send an email or call 312-926-4000.
Last UpdateJanuary 28, 2014
top