Finding the Right Treatment for Heart Failure

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The Basics of Treating Heart Failure

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Senior African American male patient holding prescription bottle with doctor

According to a recent report from the American Heart Association, an estimated 6.2 million adult Americans have heart failure–and that number is expected to increase in the coming years. Heart failure is a condition in which your heart can’t adequately supply your body with the blood it needs, depriving your body’s tissues of sufficient oxygen and nutrients. Blood may also back up into your veins and cause fluid to build up in parts of your body like your legs and lungs. You may feel symptoms such as shortness of breath, fatigue, and weakness. Heart failure is considered a lifelong disease and treatment is focused on strengthening the heart and improving symptoms. Most people with heart failure will require the use of medication, or combination of medications, as part of their treatment plan, in addition to making lifestyle changes.

What heart failure medications are commonly used?

There are several classes of medications used to treat heart failure. Your doctor will look at your individual case to determine which medications might be best for you. This may include one or more of the following:

  • Angiotensin-converting enzyme (ACE) Inhibitors: This class of medication lowers your blood pressure and reduces the amount of stress on your heart by blocking stress hormones. Captopril (Capoten) and enalapril (Vasotec) are common ACE inhibitors.

  • Beta blockers: This group of heart failure meds also decreases your blood pressure and blocks harmful stress hormones. Beta blockers slow your heart rate as well, helping your heart not to work as hard. Metoprolol succinate (Toprol XL) is an example.

  • Diuretics: Sometimes referred to as water pills, diuretics relieve your body of excess fluid by increasing how much you urinate. If you have fluid in your lungs or in your legs, a diuretic can help you breathe easier and feel better. But diuretics can also make you lose important minerals, like potassium and magnesium, so you may need to take supplements and have your electrolyte levels monitored. Frequently prescribed diuretics include furosemide (Lasix) and bumetanide (Bumex).

  • Aldosterone antagonists: These heart failure meds block aldosterone, another stress hormone that can worsen heart failure. They also act as a diuretic, getting rid of extra fluid through your urine. However, they prevent your body from getting rid of too much potassium, compared to stronger diuretics. An example is spironolactone (Aldactone).

  • Angiotensin II receptor blockers (ARBs): These medications, including candesartan (Atacand) and losartan (Cozaar), help relax your blood vessels and lower your blood pressure. They may be prescribed for people who are unable to tolerate ACE inhibitors.

  • Digoxin: This medication helps strengthen your heart’s contractions, allowing it to pump more blood. It may also decrease your heartbeat.

  • Combination medications: Sometimes, a combination of drugs is the best way to treat heart failure. For example, doctors may prescribe isosorbide dinitrate and hydralazine together, which work to relax constricted blood vessels, making it easier for your heart to pump. It’s been shown to be particularly helpful for African Americans with heart failure. Another combination medication, Entresto, marries a blood pressure drug called sacubitril with an ARB called valsartan. Taken as one pill, this drug improves blood flow to the kidneys to prevent fluid build-up, while also keeping blood pressure down. It’s been shown to reduce hospitalizations and save lives for people with chronic heart failure.

It’s important to always take your medication as prescribed, which means taking the right dose at the right time. Be sure to ask your doctor if you have any questions about why you are taking a particular medication, what you should expect from it, and what side effects may occur. Don’t ever just stop taking a medication without talking to your doctor. If you are feeling worse or struggling with side effects, your doctor may be able to adjust your dose or try a new medication to help you achieve the best results from your heart failure therapy.

What lifestyle changes are commonly recommended for heart failure?

In addition to medications, it’s imperative that people with heart failure commit to living a healthy lifestyle. This can mean big changes for some people, but it’s helpful to start by taking baby steps and not changing everything all at once. People living with heart failure should try to:

  • Quit smoking: Nicotine can temporarily increase your heart rate and blood pressure, making your heart work even harder. Smoking can also cause the blood vessels that feed your heart to clump together. People who kick the habit increase the chances that their heart failure symptoms will improve.

  • Limit fluid intake: With heart failure, the body often retains too much fluid. That’s why it’s important to limit how much fluid you consume each day; your doctor will help determine how much liquid you should take in.

  • Avoid or limit alcohol: Drinking too much alcohol can raise your triglyceride levels and increase your chance of heart attack or stroke, so it’s best to cut it out entirely. If it’s too difficult to quit, ask your doctor if it’s safe for you to consume a small amount of alcohol.

  • Avoid or limit caffeine: High doses of caffeine can temporarily raise your heart rate and blood pressure, just like consuming nicotine. If you must drink caffeine, stick to one or two cups of coffee or tea a day–and avoid adding cream or sweeteners, which add calories and fat. Similarly, refrain from drinking sugary sodas, as they contain very high amounts of caffeine in a single serving and are chock-full of sugar and additives.

  • Follow a heart-healthy diet: To keep your heart as healthy as possible, stick to a balanced diet full of fruits, vegetables, whole grains, low-fat dairy, poultry and fish (without the skin), nuts, legumes, and non-tropical vegetable oils (like canola, corn, olive, and peanut oils). Stay away from items with too much salt, saturated and trans fats, red meat, and sweets.

  • Exercise: Regular physical activity can help your heart (as well as the rest of your body) stay strong. Talk to your doctor about the best exercise regimen for you. A cardio rehabilitation program in which you’re guided through activities that can strengthen your heart muscle, may benefit you as well.

  • Reduce stress: Mental health can seriously affect physical health, especially when it comes to your heart. Do your best to stay on top of your stress levels by meditating, practicing mindfulness, seeing a therapist, or more. Your doctor can point you in the right direction if you need help getting started.

It’s possible to live a full life with heart failure–you just need to make some changes and commit to taking necessary medications. Develop a strong relationship with your cardiologist so you receive the support and guidance you need to keep your heart going strong.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Feb 24
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