Heart Failure

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Care & Treatment

Managing heart failure means finding and treating the causes. Conditions such as diabetes and high blood pressure should be treated. People with heart failure should stop smoking and limit alcohol.

Lifestyle Changes and Rehabilitation

Salt intake, fluid intake, exercise, and weight checks are important for people with heart failure.

  • Salt intake. Most people with heart failure should limit salt to less than 3 grams per day. People with severe heart failure may need even less. Some people may struggle to eat enough while on a low-salt diet. In these cases, using herbs and spices for flavor may help. Talk with your healthcare provider about what is right for you.
  • Fluid Intake. Limiting fluids is usually only needed for people with severe heart failure. However, people with heart failure should avoid drinking too much fluid.
  • Exercise. Regular physical activity can improve heart health. The type, length, and intensity of exercise should be based on your health and ability. Talk with your healthcare provider before starting an exercise program.
  • Check your weight daily. Weigh yourself every morning after using the bathroom and before eating. Wear the same amount of clothing each time. Keep a daily weight record. Call your healthcare provider if your weight goes up by 2 to 3 pounds in a short time.

Cardiac Rehabilitation

Cardiac rehabilitation is helpful for people with stable heart failure symptoms and an ejection fraction of 35 percent or less. This program includes supervised exercise, education, and support. It has been shown to help older adults with heart failure. Medicare usually covers this service.

Heart Disease Management Program 

Older adults with moderate or severe heart failure may benefit from a disease management program. These programs take a team approach. They help people manage medications, diet, symptoms, and follow-up care.


Medications for Treating Heart Failure

Several medicines are commonly used to treat heart failure.

Diuretics (Water Pills)

Diuretics help the body remove extra fluid.

Side effects may include:

  • More frequent urination
  • Low blood pressure
  • Changes in electrolyte levels (such as sodium or potassium)

By removing extra fluid, these medicines reduce swelling and decrease the workload on the heart. Diuretics are usually taken as pills. In the hospital, they may be given through a vein (intravenously, or IV).

Angiotensin-Converting Enzyme (ACE) inhibitors

ACE inhibitors help relax blood vessels and make it easier for the heart to pump.Possible side effects include:

  • Very low blood pressure
  • Higher potassium levels in the blood
  • A dry cough
  • Changes in taste

Your healthcare provider should check your blood pressure, kidney function, and electrolyte levels while you are taking these medicines.

Other Medications for Heart Failure

Depending on the type and severity of heart failure, your healthcare provider may also prescribe:

  • Angiotensin II receptor blockers (ARBs). These may be used if you cannot tolerate ACE inhibitors or as an alternative in some cases.
  • ARNI (angiotensin receptor–neprilysin inhibitors). These medicines lower blood pressure and help protect the heart.
  • Beta-blockers. These slow the heart rate and reduce stress on the heart. Common beta-blockers for heart failure include carvedilol, metoprolol succinate, and bisoprolol.
  • Hydralazine and nitrates. These medicines widen blood vessels to improve blood flow.
  • Aldosterone blockers. These reduce salt and fluid buildup in the body.
  • SGLT2 inhibitors. These medicines lower blood sugar and help the body remove extra fluid.
  • Digoxin. This medicine may help people who still have symptoms after taking other heart failure medications. It may also help if other medicines cause side effects.

Choosing the Right Medications

People with heart failure often need several medicines at the same time. Many also take medicines for other health problems.

When choosing treatment, healthcare providers consider:

  • The number of medicines you are taking
  • Possible drug interactions
  • Side effects
  • Cost
  • Quality of life
  • Life expectancy

The goal is to find a treatment plan that is safe, effective, and fits your needs.


Devices for Treating Heart Failure

Some people with heart failure may benefit from medical devices. These devices can improve symptoms and help people live longer.

Implantable Cardioverter-Defibrillators (ICDs)

An ICD is a small, battery-powered device placed under the skin. It watches the heart’s rhythm. If the heart beats in a dangerous way, the ICD sends an electric shock to restore a normal rhythm.

ICDs can lower the risk of sudden cardiac death in certain people with heart failure.

Possible concerns include:

  • Quality of life may decrease if a person receives one or more shocks.
  • Some shocks may not be needed. In older devices, up to 10 percent of shocks happened when the abnormal rhythm was not life-threatening.

Cardiac Resynchronization Therapy (CRT)

CRT is used for people with advanced heart failure and reduced ejection fraction who still have severe symptoms.

This treatment involves placing a special pacemaker in the body through surgery. The device helps the two lower chambers of the heart (ventricles) beat in a more coordinated way. This can improve how well the heart pumps blood.

Left Ventricular Assist Devices (LVADs)

An LVAD is a mechanical pump that is placed inside the body during surgery. It helps the left ventricle (the main pumping chamber) move blood through the body.

Devices for heart failure can improve quality of life and length of life in the right patients. However, possible risks and side effects must be considered along with the benefits.

As a person nears the end of life, it is important to talk with healthcare providers about whether and when to turn off these devices.

 

Last Updated April 2026

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