Treatment and Prevention
All treatment for CHF should be carried out under the supervision of a doctor. CHF usually is managed with lifestyle adjustments and medications. If you have CHF, you may have to make some of the following lifestyle adjustments:
- Cut back on fluids. Weighing yourself daily is often necessary to help adjust fluid intake and medications.
- Stay active, but avoid triggering CHF symptoms.
- Lower sodium intake to 2.3 g daily or less. If possible, try for 1.5 g or less each day. Less sodium reduces fluid retention.
- Wear special elastic stockings to reduce swelling in the legs caused by fluid retention.
- Follow an appropriate weight-loss program (for those who need it).
Congestive heart failure can be treated with the following medications:
- ACE inhibitors (e.g., enalapril*, lisinopril) expand blood vessels, allowing blood to flow more easily and making the heart's work easier or more efficient.
- Angiotension receptor blockers (ARBs; e.g., candesartan, valsartan) may be useful in place of ACE inhibitors when they cannot be used or sometimes in addition to ACE inhibitors.
- Certain beta-blockers (e.g., bisoprolol, carvedilol, metoprolol) have been proven to help improve heart function
- Digoxin increases the force of the pumping action of the heart.
- Diuretics (e.g., furosemide, hydrochlorothiazide) help the body eliminate excess salt and water.
- Spironolactone, also a diuretic, maintains potassium stores. In severe cases of heart failure, spironolactone may prevent its worsening.
- Hydralazine and nitrates (e.g., isosorbide dinitrate, nitorglycerin patch) may be useful in place of ACE inhibitors or ARBs when they cannot be used, or sometimes in addition to other therapies when symptoms are still present.
Your doctor may prescribe these medications, usually in combination, to manage your CHF. In some cases, surgery may be necessary to help improve heart function.
CHF can't always be prevented, but there are many things you can do to help. Try preventing CHF by practicing good heart health. This will also guard against heart attack, stroke, and coronary artery disease. Tips to follow include these:
- Control high blood pressure.
- Eat a healthy diet.
- Exercise.
- Stay in control of blood sugar levels (especially if you have diabetes).
- Maintain good blood cholesterol levels.
- Quit smoking.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
Glenn Gandelman, MD, MPH, FACC Assistant Clinical Professor of Medicine at New York Medical College, and in private practice specializing in cardiovascular disease in Greenwich, CT. Review provided by VeriMed Healthcare Network.