For many people, a heart-failure diagnosis can be overwhelming, with thoughts ranging from “why me?” to “what’s next?” If you find yourself asking these same questions, know that you’re far from alone. Just over five million Americans have heart failure, according to the Centers for Disease Control. Each year, 550,000 new cases are diagnosed.
And all those people have a whole lot of doctor visits: 11 million a year.
But there is some good news buried in all those numbers: Heart failure is treatable in most people. Its symptoms can be managed, and healthy lifestyle changes can make the heart stronger, allowing you to live longer.
However, how well you do depends a lot on, well… you! Do nothing, and your heart-failure will almost definitely get worse. Take action, and your heart may respond in kind. The condition can’t be cured but it certainly doesn’t have to mean the end of your life as you know it, either.
Heart failure is a diagnosis that can result from many different causes. For example, it can result from a heart attack, from a genetically abnormal heart muscle, diseases of the heart valves, high blood pressure, or alcohol/drug use among other causes.
What do you say? Ready to take some control? Here are some ways to start.
Create a Medicine Routine
Taking your medicines religiously, every day and on time as directed, can be a game changer for people with heart failure. The reason? Your heart is exhausted and not working efficiently—and certain medicines can have a direct effect on easing its demands.
Some people take blood-pressure medicines for heart failure, for example, which lightens the muscle’s workload. Along with lowering blood pressure, ACE inhibitors also boost blood flow by relaxing blood vessels. And beta blockers help by slowing down your heart rate, which gives it more time to rest in between pumps.
But these good things can only happen when the key medicines are in your body. Along with healthier habits, “the best way to reverse or improve heart failure is to take your prescribed medications,” says Jennifer Haythe, M.D., a cardiologist at Columbia University Irving Medical Center in New York City.
The first step in getting motivated to create a medicine routine is to understand what you’ve been prescribed, and why. Ask your doctor for specifics on what time of day should you take your meds and whether it matters if you take them with food or on an empty stomach.
It’s good practice to tie taking your medicines to daily rituals like shaving in the morning, for example, or brushing your teeth at night, because you’ll want to take them at the same time every day. A weekly or monthly pill organizer can help, both to help you stay aware of when you might need to order refills, and to eliminate doubt about whether you’ve remembered to take them. Electronic pill boxes can be set up to “beep” when it’s time for your meds.
Sometimes, a doctor can prescribe a fixed-dose combination of your meds, which make things easier to track by combining several drugs in one pill, or by prescribing extended-release formulas that you don’t have to take as often.
Get Honest About Snoring
If your partner says you snore, believe them! Then ask your doctor if you should be screened for sleep apnea, a common problem that interferes with breathing when tissue at the back of your throat relaxes and blocks your airway. When oxygen levels drop, your body goes on alert and pumps out adrenaline (a stress hormone) to fix the problem—and you gasp for air.
As stress-hormone levels stay high over the course of the night (and subsequent nights), your blood pressure and heart rate increase, too. All of this makes things hard on your heart and can lead to worsening symptoms of heart failure, including fluid buildup (edema) and fatigue, according to research published in the journal Sleep Medicine Clinics. In fact, there’s evidence that untreated sleep apnea may raise the risk of dying from heart disease (of all types) as much as five times, according to Harvard Medical School.
So get tested for sleep apnea and then, if you need to, strap on that CPAP machine every night—or whatever snoring solution your doctor recommends. (CPAP stands for Continuous Positive Airway Pressure, and it can help keep your breathing regular throughout the night.)
Commit to Quit—for Real
You probably don’t need a refresher on the hazards of smoking and what it can do to your heart, from damaging the muscle itself to leading to a narrowing and hardening your arteries.
But you might want a reminder of all the tools and strategies to make you a successful quitter. If you're a smoker, just do whatever you can to quit now, says Victoria Shin, M.D., a cardiologist with Torrance Memorial Medical Center in California. Experts at the National Heart, Lung, and Blood Institute suggest that you:
- Make a list of reasons why you want to quit
- Write a “quit contract” for yourself
- Know your triggers for craving a smoke so you can avoid them
- Announce a quit date to friends and family to make it official
- Brainstorm things you can do instead of smoking
Also check out the tools on smokefree.gov, including chat and text options, social media links, apps, and other quit-plan builders.
Get Moving. Even a Little
No need to be intimidated if exercise isn’t your thing. Even very small steps can make a big difference. Just as with people who haven’t had heart failure, exercise can get your heart pumping and the rest of your cardiovascular system working. Don’t do much of anything, and your body and your heart will get weaker.
“Patients can improve their recovery and prognosis with medication compliance [taking your medicines!]—and a cardiac-rehabilitation program of physical exercise,” explains Dr. Shin. With formal cardiac rehab, you’ll get evaluated by your doctors and will be given a physical-activity plan tailored specifically for you. These programs usually involve exercise counseling and training, education about healthy living, and strategies for controlling stress in your life—which can hurt your heart.
Check with your doctor about whether this type of structured program might be right for you. The American Heart Association has information on how to figure out if you’re eligible for it. If you’re not, or can’t afford it, it’s still important to do something! Your doctor will be able to tell you what level of activity is safe to start with and may order an exercise stress test to see how much exertion you can safely handle. He or she can also share warning signs to watch for as you start to move more, such as shortness of breath.
Then it’s up to you to get moving. Look for opportunities big and small, whether it’s swimming, biking, or something else. And remember that even very small steps, like taking a walk to the grocery store rather than the car, or opting for the steps over the elevator, can make a difference over time.
Aim to Eat Cleaner
Diets high in fat and sugar, like what you get when you eat a lot of processed foods, can force your heart to work harder by clogging key arteries with plaque, says Dr. Shin.
If you have a lot of cleaning up to do with the foods you eat, try to fill your plate with mostly fruits, vegetables, and whole grains. Since things can get overwhelming pretty quickly, don’t hesitate to just try focusing on one thing at a time. For example:
- Substitute salt with herbs and spices, and olive oil for butter
- Swap soda or other sugar-sweetened drink with water or seltzer. If you want some flavor, try adding a spritz of lemon or lime.
- Commit to just one serving of red meat for the week.
- Try having a handful of unsalted nuts instead of a bag of chips at the office every day
Little things add up!