Lifestyle Changes
Between 30 - 47% of patients who require hospitalization for heart failure are back in the hospital again within 6 months. Many people return because of lifestyle factors, such as poor diet, failure to comply with medications, and social isolation.
Home Support and Rehabilitation Programs
In one study, elderly people who had no emotional support at home had triple the risk of a heart attack after hospitalization for heart failure than those who did have such support. (Women had eight times the risk.) In another study, the greatest risk factor for death and readmission to the hospital after a first hospitalization was being single, regardless of the health of the patient at discharge. A third study confirmed that a strong marriage predicted long-term survival. Evidence continues to mount that programs that offer intensive follow-up to ensure that the patient complies with lifestyle changes and medication regimens at home are reducing rehospitalization rates and improving survival. Patients without available rehabilitation programs should seek support from local and national heart associations and groups.
Monitoring Weight Changes
Patients should weigh themselves each morning and keep a record. Any changes are important:
- A sudden increase in weight of more than two or three pounds may indicate fluid accumulation and should prompt an immediate call to the doctor.
- Rapid wasting weight loss over a few months is a very serious sign and may indicate the need for surgical intervention.
Dietary Factors
Mediterranean Diet. Evidence suggests that the Mediterranean diet helps protect the heart and may even reduce the risk for heart failure after a first heart attack. The diet emphasizes whole grains, fish, olive oil, garlic, and moderate daily intake of wine, which may have many benefits for the heart. The diet recommends:
- A relatively high fat intake (about 35 - 45% of daily calories) mostly in monounsaturated and polyunsaturated fats. The Mediterranean diet is known for its use of olive oil, but the greatest benefits found in a major study of this diet appeared to be derived from the use of canola oil, which is rich in omega-3 fatty acids. Olive oil, in fact, does not contain omega-3 fatty acids. On the other hand, olive oil may have beneficial effects independent from those on lipids, such as improving insulin and blood glucose levels and reducing blood pressure.
- Daily glass or two of wine.
- Most protein comes from fish. The diet avoids high-fat dairy and meat products. Although fish and fish oil are good for the heart, patients who have an implantable defibrillator should not take fish oil supplements. A 2005 study suggested that these supplements may worsen heart rhythm problems in some patients.
- Plenty of fresh fruits and vegetables, as well as nuts, legumes, beans, and whole grains.
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