Heart Failure Treatment

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Heart failure has no cure. But treatment can help you live a longer, more active life with fewer symptoms. Treatment depends on the type of heart failure you have and how serious it is.

Your provider may recommend these heart-healthy lifestyle changes alone or as part of a cardiac rehabilitation plan:

• Lower your sodium (salt) intake. Salt may make fluid buildup worse. View our Tips To Reduce Salt and Sodium fact sheet.
• Aim for a healthy weight since extra weight can make your heart work harder.
• Get regular physical activity. Ask your healthcare provider about how active you should be, including during daily activities, work, leisure time, sex, and exercise. Your level of activity will depend on how serious your heart failure is. Sometimes, your provider might recommend outpatient cardiac rehabilitation services to improve your exercise level and reduce your risk factors.
• Quit smoking. Smoking and Your Heart has for more information. For free help quitting smoking, you may call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).
• Avoid or limit alcohol. Your provider may recommend that you limit or stop drinking alcohol. You can find resources and support at the National Institute on Alcohol Abuse and Alcoholism’s Alcohol Treatment Navigator.
• Manage contributing risk factors. Controlling some of the factors that may worsen heart failure like blood pressure, heart rhythm, and anemia will often improve heart health.
• Manage stress. Learning how to manage stress and cope with problems can improve your mental and physical health. Relaxation techniques, talking to a counselor, and finding a support group can all help lower stress and anxiety.
• Get good-quality sleep. Sleep disorders such as sleep apnea are common in people who have heart failure. Treating your sleep disorder helps improve your sleep and may help improve your heart failure symptoms.

Read about healthy lifestyle changes in Heart-Healthy Living.

Left-sided heart failure

The following medicines are commonly used to treat heart failure with reduced ejection fraction.

• Medicines that remove extra sodium and fluid from your body, including diuretics and aldosterone antagonists (such as spironolactone) lower the amount of blood that the heart must pump. Very high doses of diuretics may cause low blood pressure, kidney disease, and worsening heart failure symptoms. Side effects of aldosterone antagonists can include kidney disease and high potassium levels.
• Medicines to relax your blood vessels makes it easier for your heart to pump blood. Examples include ACE inhibitors and angiotensin receptor blockers (ARBs). Possible side effects include cough, low blood pressure, and short-term reduced kidney function.
• Medicines to slow your heart rate, such as beta blockers and ivabradine make it easier for your heart to pump blood and can help prevent long-term heart failure from getting worse. Possible side effects include a slow or irregular heart rate, high blood pressure, and fuzzy vision or seeing bright halos.
• Newer medicines, including two new groups of medicines approved to lower blood sugar in patients with diabetes, called sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide (GLP) agonists. They may also reduce heart failure hospitalizations. Their use in treating heart failure is currently being studied.
• Digoxin makes your heart beat stronger and pump more blood. This medicine is mostly used to treat serious heart failure when other medicines do not help improve your symptoms. Side effects may include digestive problems, confusion, and vision problems.

Currently, the main treatments for heart failure with preserved ejection fraction are diuretics. Your doctor also may prescribe blood pressure medicines to help relieve your symptoms.

If you have heart failure with reduced ejection fraction and it worsens, you may need one of the following medical devices:

• A biventricular pacemaker, also called cardiac resynchronization therapy, can help both sides of your heart contract at the same time to relieve your symptoms.
• A mechanical heart pump, such as a ventricular assist device or a total artificial heart may be used until you have surgery or as a long-term treatment.
• An implantable cardioverter defibrillator (ICD) checks your heart rate and uses electrical pulses to correct irregular heart rhythms that can cause sudden cardiac arrest.

You may also need heart surgery to repair a congenital heart defect or damage to your heart. If your heart failure is life-threatening and other treatments have not worked, you may need a heart transplant.

For people with heart failure and preserved ejection fraction, there are no currently approved devices or procedures to improve symptoms. Researchers are continuing to study possible treatments.